Risks and benefits of gallbladder removal

Overview

Gallbladder removal is an operation to take out the gallbladder, a small pear-shaped organ under your liver that stores bile (a digestive fluid). This surgery is usually done when gallstones cause pain or other problems.

Yes, gallbladder removal is a frequently performed surgery. In the UK, around 70,000 operations are done each year.

It affects people of all ages, but it is more common in women, people over 40, and those who are overweight or have a family history of gallstones.

Symptoms

Common symptoms

• Sudden, sharp pain in the upper right belly that may spread to the back or right shoulder blade
• Pain after eating, especially after a fatty meal
• Nausea or vomiting
• Feeling bloated or having indigestion

Symptoms in children

• Abdominal pain that comes and goes after meals
• Nausea and vomiting
• Sometimes jaundice (yellowing of the skin or eyes)

Symptoms in older adults

• Dull pain in the belly that may be less sharp than in younger people
• Fever without obvious cause (from infection)
• Confusion or feeling very unwell (signs of a serious infection)

Causes

Main causes

• Gallstones (hard pebble-like deposits in the gallbladder) that block the outlet
• Inflammation of the gallbladder (cholecystitis) often caused by gallstones
• Gallstone pancreatitis (when a stone blocks the pancreas duct)
• Bile duct stones or sludge (thickened bile) that cause symptoms

Risk factors

• Being overweight or obese
• Rapid weight loss (such as after bariatric surgery or very low-calorie diets)
• A diet high in fat and low in fibre
• Being female and over 40
• Pregnancy or using hormone replacement therapy
• Having diabetes or certain blood disorders (like sickle cell disease)
• Family history of gallstones

When to see a doctor

See a doctor urgently if:

• If you have severe belly pain that doesn't go away after a few hours
• If you have a fever with belly pain
• If your skin or eyes look yellow
• If you have been told you have gallstones and develop new symptoms

Book a routine appointment if:

• If you have mild belly pain that comes and goes after meals
• If you often feel bloated or have indigestion that is not helped by diet changes
• If you have a family history of gallbladder disease and want to talk about your risk

Diagnosis

Your doctor will ask about your symptoms and feel your belly. They may order tests to see if you have gallstones or inflammation.

Tests that may be done

• Ultrasound scan (uses sound waves to create pictures of your gallbladder)
• Blood tests (to check for infection or liver problems)
• HIDA scan (inject a dye to see how your gallbladder works)
• CT scan (if results are unclear or to check for other problems)

What to expect at your appointment

An ultrasound is painless and takes about 15 minutes. Your doctor will discuss the results and if surgery is recommended. If you need surgery, you will meet a surgeon who explains the procedure and recovery.

Treatment

Treatment for gallbladder problems depends on your symptoms and test results. If you have few symptoms, you may only need to watch and wait. Surgery is the most common treatment when symptoms are bothersome or when complications arise.

Self-care at home

• Eat a low-fat diet to reduce symptoms (avoid fried foods, fatty meats, and full-fat dairy)
• Drink plenty of water to help keep bile thin
• Keep a healthy weight – lose weight slowly if needed (rapid weight loss can make gallstones worse)
• Try over-the-counter pain relief such as paracetamol or ibuprofen for mild pain (check with your pharmacist)

Medical treatments

If surgery is not suitable for you, your doctor may discuss using medicines that help dissolve certain types of small gallstones. These medicines are taken as tablets for months or longer, but they work only in some people and gallstones may come back. Your doctor will decide if this is an option for you.

When is surgery considered?

Surgery (cholecystectomy) is recommended when you have repeated pain, infection, or gallstones that block the bile duct. It is often done as keyhole surgery (laparoscopic) with small cuts, so recovery is quicker. Most people can go home the same day or after one night in hospital.

Living with this condition

After surgery, you can return to normal activities gradually. Many people feel back to themselves within 2 to 4 weeks. You may notice changes in your digestion, especially after fatty meals, but this usually improves over time.

Lifestyle tips

• Eat smaller, more frequent meals at first to help digestion
• Avoid very fatty or greasy foods for the first few weeks after surgery
• Stay active with gentle walking, but avoid heavy lifting or strenuous exercise until your surgeon says it's safe
• Take care of your wound – keep it clean and watch for signs of infection (redness, swelling, discharge)

Diet and exercise

A healthy diet with plenty of fibre (whole grains, fruits, vegetables) and lean protein helps your body adjust. Gentle exercise like walking aids recovery. Over time, most people can eat normally, but if certain foods still cause discomfort, avoid them. Your GP or dietitian can give personalised advice.

Mental health and emotional wellbeing

Having surgery can be stressful. You may feel anxious before the procedure or low during recovery. It is normal to need time to adjust. If you feel overwhelmed, talk to your healthcare team or a mental health professional. Remember, if you are in crisis or thinking about harming yourself, please call your local emergency number or a helpline immediately.

Prevention

There is no sure way to prevent gallstones, but a healthy lifestyle can lower your risk. Avoid rapid weight loss, eat a balanced diet with enough fibre, and maintain a healthy weight. If you have had gallstones before, these steps may help reduce the chance of new stones forming.

Vaccines

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Screening programmes

Routine screening for gallstones is not recommended for most people. If you have a strong family history or certain risk factors, talk to your doctor about whether you should be checked.

Complications

If left untreated

• Infection of the gallbladder (cholecystitis) – can cause severe belly pain and fever
• Blockage of the bile duct – can lead to jaundice and serious infection in the bile system
• Pancreatitis (inflammation of the pancreas) – a painful and potentially dangerous condition
• Gallstone ileus (a rare but serious blockage in the intestine caused by a large gallstone)

Long-term outlook

Most people who have gallbladder removal surgery do very well. The operation is safe and effective, and you can live a normal, healthy life without a gallbladder. With a healthy diet and lifestyle, long-term problems are rare. If you decide not to have surgery, you can manage mild symptoms with diet changes, but there is a risk of complications if stones cause a blockage or infection.

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