Do I Need Surgery for Gallstones?

Your gallbladder is a pear-shaped organ that stores bile, the fluid that helps digest food. If it’s not working the way it should (or your bile gets out of balance), hard fragments start to form. These can be as small as a grain of rice or as big as a golf ball.

Gallstones don’t go away on their own. If they start to hurt or cause other symptoms, your doctor may decide to remove your gallbladder. This type of surgery is called a cholecystectomy. It’s one of the most common surgeries doctors perform.

About 80% of people who have gallstones will need surgery.

Types of Gallbladder Surgery

Doctors can remove your gallbladder in one of two ways:

Open surgery: During this procedure, your surgeon will make a 5- to 7-inch incision (cut) on your belly to take out your gallbladder. You’ll need open surgery if you have a bleeding disorder. You may also need it if you have severe gallbladder disease, are very overweight, or are in your last trimester of pregnancy.

Laparoscopic cholecystectomy: Doctors also call this “keyhole surgery.” Your surgeon doesn’t make a big opening in your belly. Instead, he makes four small cuts. He inserts a very thin, flexible tube that contains a light and a tiny video camera into your belly. These help your surgeon see your gallbladder better. Next, he’ll insert special tools to remove the diseased organ.

For both types of surgery, you’ll be given general anesthesia. This means you’ll sleep through the procedure and won’t feel any pain while it’s being done.

Do I Need Surgery?

If your gallstones aren’t causing symptoms, there’s no need for you to have surgery. You’ll only need it if a stone goes into, or blocks, one of your bile ducts. This causes what doctors call a “gallbladder attack.” It’s an intense, knife-like pain in your belly that can last several hours.

If left untreated, gallstones can also lead to more serious problems, like:

  • Cholecystitis -- an inflamed gallbladder
  • Pancreatitis -- an inflamed pancreas
  • Cholangitis -- inflamed bile ducts

Before your doctor opts for surgery, he’ll run several tests to see the effect your gallstones are having on your health. Tests might include:

  • Blood test
  • Ultrasound
  • MRI HIDA (hepatobiliary iminodiacetic acid) scan -- a radioactive chemical is put into your body to create images of any blocked ducts
  • Endoscopic ultrasonography -- an imaging device is put into your mouth and down through your digestive tract so sound waves can create a detailed picture of your small intestine

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Can I Try Other Treatments First?

You may be able to manage your symptoms for a short time by making changes to your diet. This includes cutting back on fatty foods. But dietary changes don’t always help prevent gallbladder attacks.

If surgery isn’t an option for you, your doctor can prescribe a medication to dissolve your gallstones. But this can take months or even years to work. And even if your gallstones do go away, there’s a chance they’ll return.

Gallbladder Surgery Risks

You can live without your gallbladder. Your liver can make enough bile on its own. This will naturally find its way into your small intestine even if your gallbladder is removed.

Doctors believe gallbladder surgery is safe, but some problems can still arise. These may include:

  • Problems with anesthesia
  • Infection
  • Bleeding
  • Swelling
  • Bile leakage
  • Damage to a bile duct
  • Damage to your intestine, bowel, or blood vessels
  • Deep vein thrombosis (blood clots)
  • Heart problems
  • Pneumonia

You also run the risk of a problem doctors call “post-cholecystectomy syndrome” (PCS). It can happen if any gallstones are left in your bile ducts or bile happens to leak into your stomach. The symptoms of PCS are similar to those of gallstones. They include belly pain, heartburn, and diarrhea.

Recovery

The length of time it takes you to heal depends on the type of surgery you have.

If you have your gallbladder removed during open surgery, you’ll need to stay in the hospital for a few days afterward. It may take between 6 to 8 weeks for your body to heal fully.

Laparoscopy is less involved, so you’ll have less pain and heal faster than if you have open surgery. Most people who have it are able to go home from the hospital the same day. You’ll likely be back to your normal routine within 2 weeks.

WebMD Medical Reference Reviewed by William Blahd, MD on April 02, 2017

Sources

SOURCES:
University of California San Francisco Medical Center: “Gallstones.”

Society of American Gastrointestinal and Endoscopic Surgeons: “Laparoscopic Gallbladder Removal (Cholecystectomy) Patient Information from SAGES.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Dieting and Gallstones.”

Harvard Health Publications: “What to To Do About Gallstones?”

NHS Choices: “Gallstone Treatment,” “Gallbladder Removal -- Complications,” “Gallbladder Removal -- What Happens.”

Mayo Clinic: “Cholecystectomy (Gallbladder Removal),” “Endoscopic Ultrasound.”

Better Health Channel/State Government of Victoria, Australia: “Gallbladder: Gallstones and Surgery.”

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