Respected user, hi I evaluated your query thoroughly . * According to your narration , your friend is suffering from disorder involving liver / gall bladder / pancreas / colon . * Definite diagnosis is to be evaluated by detail physical history , examination assessment of supportive data as laboratory findings, radiological evaluations etc. * So the need for immediate surgery or operation can not be decided by this 5 questions along , it require intensive work up of the case as a whole . Hope this helps you . Welcome for any further assistance . Thanks for using Healthcaremagic.com & giving me an opportunity to assist Wishing your friend fine recovery . Regards dear take care .