What are gallstones?
Gallstones are solid deposits in the gallbladder, a small organ beneath the liver that stores bile. A stone can block the gallbladder outlet or the main bile duct. This may cause pain beneath the right ribs or in the upper middle abdomen, often with nausea or vomiting.
Once gallstones have caused pain, further attacks are common and can lead to inflammation, jaundice or pancreatitis. Bloating or indigestion alone may have another cause, so your symptom pattern is checked before surgery is planned.
An ultrasound may also show sludge (thickened bile) or a gallbladder polyp. Sludge can cause the same pain as stones and is treated the same way when it does. Most polyps are harmless. A polyp of 10 mm or more, or one that is growing, is usually removed with the gallbladder; smaller ones are checked with repeat scans.
What are the symptoms of gallstones?
Many gallstones cause no symptoms and are found on a scan done for another reason. When a stone blocks the gallbladder outlet or the bile duct, symptoms can include:
- Pain beneath the right ribs or in the upper middle abdomen, often after a fatty meal
- Pain that spreads to the right shoulder or the back
- Nausea or vomiting with the pain
- Fever, yellow eyes or skin (jaundice) or dark urine, which need urgent care
Bloating or indigestion alone is less typical of gallstones and may have another cause.
How are gallstones diagnosed?
Assessment usually includes an ultrasound scan and liver blood tests. A special MRI scan called MRCP may be needed if a bile-duct stone is suspected. The surgeon also reviews your pain pattern, previous attacks, other illnesses and earlier abdominal operations.
When is gallbladder surgery needed?
Laparoscopic gallbladder removal is usually recommended when stones cause typical pain or complications. Acute gallbladder inflammation often requires hospital treatment and, when the patient is fit, surgery during the same admission. Stones in the main bile duct generally require clearance even if they have not caused pain. This is usually done by ERCP, a camera procedure through the mouth, before or after gallbladder removal.
How is the gallbladder removed, and what are the risks?
Laparoscopic cholecystectomy removes the gallbladder through small abdominal incisions under general anaesthesia. The gallbladder is removed rather than taking out the stones alone. If inflammation or anatomy makes laparoscopic surgery unsafe, a larger open incision may be needed.
A bile-duct stone can be cleared during surgery or by an endoscopic procedure called ERCP. Risks of gallbladder surgery include bleeding, infection, blood clots, bile leakage, retained stones and injury to the bile duct, bowel or nearby organs. Your own risk depends on inflammation, previous surgery and general health.
Recovery after gallbladder surgery
After a planned laparoscopic operation, most patients are discharged after a one-day admission. Walking and light activity start early. Desk work is usually possible in 5–7 days; manual work and open surgery need longer.
You can live normally without a gallbladder. Small meals may feel easier at first, and persistent diarrhoea or digestive symptoms should be reviewed.
Seek prompt advice after surgery for worsening pain, fever, jaundice, vomiting, breathlessness or wound discharge.
When to seek urgent care
Go to an emergency department for severe or persistent upper abdominal pain, especially with vomiting, fever, shivering, jaundice or pain spreading to the back. These symptoms may mean an inflamed gallbladder, a blocked bile duct or pancreatitis.