<s>[INST] hi there. husband had an ultrasound yesterday. fattly liver (diagnosed previously) but new is echogenic sludge within the gallbladder , no frank gallbladder wall thickening or pericholecystic fluid. Bile duct ULN at 5mm. PCP has recommended surgical consult. wondering if there are other options and how serious this is [/INST] Hello! Thank you for the query. Bile sludge if it gives no symptoms is not and indication for surgery. So if your husband does not suffer from stomach aches, especially after a meal, nausea, gallbladder removal is not necessary. However, it is advisable to have abdominal ultrasound repeated from time to time (every year) as such sludge can lead to gallstones. Bile sludge is mostly composed of cholesterol crystals and calcium salts. The cause of it can be fatty diet. So it is advisable to reduce fatty foods. Hope this will help. Regards. </s>