Gallstones are hard deposits that form in the gallbladder. About a quarter of people with gallstones need treatment, which is usually surgery.
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), gallstones may range from the size of a grain of sand to the size of a golf ball.
Many gallstones do not cause symptoms. However, some can cause complications, such as an infection or a blocked bile or pancreatic duct.
If this happens, the blockage can cause severe and often sharp pain. In these cases, a doctor will likely recommend surgery to remove the stone.
This article discusses types of gallstone surgery, recovery, and aftercare.
Gallstones are very common, affecting 10–15% of people in the United States, according to the NIDDK. Every year, about a quarter of the people with a diagnosis of gallstones will need treatment, which is usually surgery.
However, there is a consensus among doctors from multiple specialties that people with asymptomatic gallstones should not undergo surgery due to the risk involved and the lack of any clear benefit.
That said, the type of gallstones a person has can make a doctor more likely to recommend surgery. There are two types of gallstones: cholesterol and pigment.
A doctor may be able to treat cholesterol stones without surgical intervention, but they would likely suggest surgery for pigment stones.
Pigment stones are stones that are brown or black. An excess amount of bilirubin in a person’s blood can cause pigment stones to form.
According to the NIDDK, some common nonsurgical procedures include:
- Shock wave lithotripsy: Though not common, a doctor may use shock waves to break the gallstone apart.
- Endoscopic retrograde cholangiopancreatography: This procedure involves using an endoscope to visualize the bile ducts. For gallstones, a doctor may use the procedure to remove a stone from a blocked duct.
- Oral dissolution therapy: A doctor may use medications, such as ursodiol and chenodiol, to break up the gallstones.
However, attempts to dissolve or break up the gallstones often do not work effectively. If they do not work, a doctor will likely recommend surgery.
If a person’s doctor recommends gallstone surgery, they will offer specific instructions about what to expect and how to prepare.
According to the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), a person will need a full physical examination before undergoing surgery to determine if they are healthy enough for the procedure.
After the examination, the surgeon can discuss the procedure, including what to expect, and answer any questions.
Though instructions will vary, the SAGES indicate that the following are common preparation instructions to receive before surgery:
- Stop eating or drinking when the doctor recommends.
- Take a shower the night before the procedure.
- Stop taking certain medications — such as supplements, blood thinners, and medications that affect the immune system — before the surgery.
- Take any approved medications the morning of the surgery with a small amount of water.
The gallbladder is not an essential organ to human life. A surgeon can safely remove the gallbladder with a surgical procedure called cholecystectomy.
There are two types of surgery for gallstones: laparoscopic/robotic and open surgery.
According to the NIDDK, surgeons are more likely to perform a laparoscopic procedure than an open procedure.
During laparoscopic cholecystectomy, a surgeon will use general anesthetics to put the person to sleep. Then, they will make three or four incisions and place devices, called ports, into the incisions to allow better access to the gallbladder.
The surgeon will use a small camera to help them remove the gallbladder, before sealing the openings with stitches or staples.
In some cases, they may use robotics to help with the surgery. These procedures are very similar to other laparoscopic cholecystectomies. The only difference is that the surgeon will manipulate the robot to perform the procedure.
During the procedure, they may need to remove gallstones that are blocking one or more bile ducts. They may need to use X-ray to help them see any additional stones.
A surgeon may perform open cholecystectomy if the laparoscopic procedure does not go well. They may also choose to perform the procedure if the gallbladder is:
- severely inflamed
- badly infected
- scarred from several other procedures
According to the SAGES, some other reasons a surgeon may switch to an open procedure include:
- bleeding issues
- overweight or obesity
- poor visibility inside the body
A person’s recovery time depends on the type of surgery they had and any complications that arose.
After laparoscopic cholecystectomy, a person can often go home the same day or the next day. They can expect to return to normal activities within 1 week.
After open cholecystectomy, a person may need to stay in the hospital for up to a week. During this time, doctors will provide follow-up care. A person can often return to normal activities within 1 month.
According to the NIDDK, complications from gallbladder surgery include a person’s bile ducts developing an infection. This may require additional surgeries.
For optimal healing, the person will need to keep the incisions clean and dry, change the bandages regularly, and follow all advice from their doctor. Taking over-the-counter pain medications can help people manage any pain.
A doctor may also recommend some short-term dietary changes, such as eating small, light meals for several days following surgery and following a low fat diet for a few weeks.
The SAGES recommend that a person be as active following the procedure as they can be. They suggest walking or doing other light exercises to help keep the body moving.
The surgeon will likely schedule a follow-up appointment for about 2–3 weeks after the procedure, according to the SAGES.
People may way to contact their doctor as soon as possible if they experience any of the following symptoms:
- a fever over 101°F (38ºC)
- jaundice, or a yellowing of the skin and eyes
- severe swelling or pain in the abdomen
- breathing issues
- nausea and vomiting
- flushed skin that spreads from the incisions
- blood or pus coming from the incisions
- pain that medication cannot relieve
According to a 2011 review of studies, there are limited quality data on long-term outcomes for people who undergo gallbladder surgery.
People may need to make some long-term dietary changes after gallbladder removal.
However, according to research in The Journal of the Academy of Nutrition and Dietetics, there is no set standard for dietary changes after cholecystectomy.
Instead, each person should have a unique dietary plan depending on how their body reacts to the loss of the gallbladder.
Research suggests that people with diarrhea after gallbladder removal should increase their fiber intake slowly over several weeks.
Gallstone surgery is a common treatment for obstructive or frequent gallstones that cause symptoms. Laparoscopic surgery is more common than open surgery.
People can talk with their doctor about the option that is right for them. They can typically expect their quality of life to improve following the procedure.