Gallstones and gallbladder removal
Stones found on an ultrasound, or upper abdominal pain after meals. Which stones need surgery, how the operation goes and what life is like without a gallbladder.
What does the gallbladder do?
The gallbladder is a small sac under the liver. It stores bile and sends it to the bowel after meals. Stones sometimes form in it. Many stones never cause symptoms and are found only on an ultrasound.
What are the signs?
Gallstone pain is usually in the upper abdomen or under the right ribs. It starts suddenly, sometimes spreads to the back or right shoulder, and may come with nausea. It often lasts a few hours and then settles.
When is it urgent?
These can mean a stone has caused a complication:
- Pain that lasts for hours and does not settle
- Pain with fever and chills
- Yellow skin or eyes, dark urine or pale stools
- Severe upper abdominal pain that goes through to the back
In these cases do not wait for an appointment. Go to the emergency department the same day.
How is it checked?
An abdominal ultrasound is the main test. Blood tests show whether there is inflammation or a blocked duct. Other imaging is sometimes needed.
Which stones need surgery?
- Stones without symptoms: most people do not need surgery. See the article What should I do about silent gallstones?
- Stones that have caused pain or a complication: removing the gallbladder is usually advised, because the pain and complications can come back.
How is the operation done?
Gallbladder removal is usually done by laparoscopy, through a few small cuts under general anaesthesia. Sometimes, for example when inflammation is severe or the view is not good enough, open surgery becomes necessary. The surgeon may decide this during the operation, and that decision is made for your safety.
Risks
Risks include bleeding, infection, bile leakage and, rarely, injury to the bile duct. Problems with anaesthesia and blood clots can happen as with any operation. Go through these with the doctor before surgery.
Life without a gallbladder
The body manages without a gallbladder, because the liver makes bile and sends it straight to the bowel. Most people eat normally. Some have bloating or diarrhoea in the first weeks, which gets better in most people. If it continues, talk to your doctor.
Frequently asked questions
Can stones be dissolved with medicine or diet?
Diet does not remove existing stones, and dissolving medicines are used only in limited cases and work less well. For stones that have caused pain, removing the gallbladder is the usual treatment.
Can they take out just the stones?
In the usual operation the gallbladder itself is removed, because stones can form again if it stays.
The first step is a calm examination.
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