Depends. If you are having pain after eating fatty meals and have a thickened gallbladder wall on ultrasound, it most likely needs surgery. A thickened gallbladder by itself on ultrasound, may be watched, depending on the situation.
Sort of.. Thickening of the gallbladder wall may indeed indicate evidence of a more serious gb attack, however it's a pretty nonspecific finding; for example, it is common in people with congestive heart failure. In the absence of symptoms, gb wall thickening does not warrant gb surgery.