if your husband does not have any symptoms then he should leave his gallbladder alone. If on the other hand he has abdominal pain in the gallbladder area (right upper quadrant of the abdominal area), then he should have his gallbladder removed electively. The bile duct at 5mm is of normal size.
For the fatty liver he should lose weight and exercise. Also if diabetic and with high cholesterol, these should be controlled.

Hello!

Thank you for the query.

Bile sludge if 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.

Hello,
Thanks for writing to us.

Echogenic material in gall bladder is debris formed in the gall bladder. In most of the cases this gall baldder sludge does not cause any problem, but in some of cases this sludge forms balls which can develop in gall stones, that can be very painful. Being overweight can also increase the risk of gallstone development. To reduce the risk of gall stone development reduce intake of fatty food.
Take care.