Gallstones: removing the gallbladder

Types

• Gallstones causing attacks of pain
• Inflamed gallbladder (acute cholecystitis)

What is the problem

The gallbladder is a small pouch under the liver that stores bile, a fluid that helps to digest fat. Stones can form inside it. When a stone blocks its outlet, it causes attacks of strong pain in the upper right belly, often after a meal and sometimes into the back or the right shoulder.

Why an operation

Once gallstones have caused pain, the attacks often come back, and stones can lead to inflammation of the gallbladder, jaundice or inflammation of the pancreas. Taking out the gallbladder with its stones prevents this. You do not need it: the liver keeps making bile, which then flows straight into the bowel.

How the operation is done

It is done as keyhole surgery (laparoscopy) through three or four small cuts. The belly is filled with gas, and the duct and the small artery of the gallbladder are closed with clips and cut. The gallbladder is freed from the liver and taken out in a small bag through one of the cuts. It usually takes about one hour. Sometimes a larger cut is needed.

Anaesthesia and the hospital stay

You will be asleep (general anaesthesia). After a planned operation most people stay one night, some go home the same day. With an inflamed gallbladder the operation is best done early, during the same hospital stay, and the stay is often a few days.

Possible risks

• Changing to a larger, open cut — about 2 to 5 in 100; more often with an inflamed gallbladder
• Bile leaking from the liver bed or the clipped duct — about 1 in 100
• Injury to the main bile duct, which may need another operation — about 3 to 5 in 1000
• Bleeding or wound infection — about 1 to 2 in 100
• A stone left in the bile duct, removed later with a camera through the mouth — about 1 to 2 in 100
• Pain in the shoulder from the gas — common, gone after a few days
• Looser stools after fatty meals — in some people; usually improves
• Belly pain or indigestion that continues after the operation — about 1 to 3 in 10, more often if the pain was not typical

After the operation

You may eat and drink normally after the operation and walk the same day. The small wounds and the shoulder hurt for a few days; normal painkillers help. Most people are back to everyday activities after one to two weeks. Avoid heavy lifting for about two weeks, or as your surgeon advises.

Questions people often ask