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Decision PointGallstones: Should I have gallbladder surgery?You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Gallstones: Should I have gallbladder surgery? Get the facts Your options
Key points to remember
FAQs
What are gallstones?Gallstones are stones made of cholesterol and other things found in bile. They form in the gallbladder or bile duct. They may be as small as a grain of sand or as large as a golf ball. Most people with gallstones have no symptoms and don't need treatment. Those who do have symptoms often have surgery to remove the gallbladder. In people who do have symptoms, the most common one is pain in the upper right area of your belly. Often the pain feels like it's in the upper belly, especially on the right side. Other symptoms include nausea and vomiting. Symptoms usually don't come back after the gallbladder has been removed. If gallstones block a duct, you may get jaundice. Jaundice makes your skin and the whites of your eyes yellow. It can also cause dark urine and light-colored stools. What is the surgery to remove the gallbladder?Laparoscopic gallbladder surgery is the most common surgery done to remove the gallbladder. The doctor inserts a lighted viewing instrument called a laparoscope and surgical tools into your belly through several small cuts. This type of surgery is very safe. People who have it usually recover enough in 7 to 10 days to go back to work or to their normal routine. Laparoscopic surgery does not remove stones in the common bile duct. Open gallbladder surgery involves taking the gallbladder out through one larger incision in your belly. Open surgery may be done if laparoscopic surgery is not an option or when problems are found during laparoscopic surgery. The hospital stay is longer with open surgery. Stones in the bile duct If gallstones are found in the common bile duct before or during surgery to remove the gallbladder, a doctor may do a procedure called an ERCP. This involves putting a tube called an endoscope down your throat to your small intestine. The doctor uses the scope to look for stones in the duct and remove them. What are the risks of gallbladder surgery?The overall risk from laparoscopic gallbladder surgery is very low. The most serious risks include:
Risks from open gallbladder surgery include:
Postcholecystectomy syndrome After gallbladder surgery (cholecystectomy), a few people have ongoing symptoms, such as belly pain, bloating, gas, or diarrhea. This is called postcholecystectomy syndrome. These symptoms can be treated with medicines. What are the risks of NOT having the gallbladder removed?There is little risk in not having surgery if you have only one mild attack. But if you have more than one painful attack, you're likely to have more in the future. The risks of not treating gallstones may include:
About 1 out of 3 people with gallstones who have a single attack of pain or other symptoms do not have symptoms again.1 That means that 2 out of 3 people do have another attack. If you decide against surgery, what can you do to prevent another attack?You may be able to prevent gallstone attacks if you:
About 1 out of 3 people with gallstones who have a single attack of pain or other symptoms do not have symptoms again.1 That means that 2 out of 3 people do have another attack. Why might your doctor recommend gallbladder surgery?Your doctor may recommend surgery if:
Compare your options Compare
Have gallbladder surgery
Have gallbladder surgery
Don't have surgery
Don't have surgery
Personal Stories Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide. Personal stories about gallbladder surgery for gallstonesThese stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions. I have had a couple of gallbladder attacks over the past few years. They weren't too bad, but I did take a sick day or two each time. Because I travel several times a month for work, I have decided to have my gallbladder removed. That way I won't have to worry about having an attack while I am away on business, possibly even out of the country. Kelly, age 43 When I was pregnant, my doctor discovered that I have gallstones. We talked it over, and it turns out that it's possible that the stomach pain I had a couple of years ago might have been related to my gallstones. I haven't had any problems since then, so we agreed to wait and see if I have another attack. If I do, we can do some tests and find out if the pain is caused by the gallstones. I don't want to have surgery if there is no need. Jackie, age 37 My first gallstone attack was pretty painful. I know I could handle another attack if it happens, but I would just as soon have surgery and know that I won't have another one. Mike, age 50 My gallbladder attacks have been pretty mild so far, and I've only had two in the past 5 years. I'm not too concerned about it. My doctor told me the signs of a more serious problem, so I feel well-prepared for another one, if it happens. We agree that I don't need surgery now. Carmen, age 50 If you need more information, see the topic Gallstones. What matters most to you? Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. Reasons to have gallbladder surgery Reasons not to have gallbladder surgery The pain from my gallstone attacks is very bad. I have had one or more gallstone attacks, but they don't hurt much. More important Equally important More important The thought of having more attacks is worse than the thought of having surgery. I want to avoid surgery if I possibly can. More important Equally important More important I do a lot of traveling to places where I may not be able to get help if I have a serious attack. I'm never too far away from medical treatment. More important Equally important More important Cost is not an issue for me. I'm not sure I can afford to have surgery. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now? Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. Having gallbladder surgery NOT having gallbladder surgery Leaning toward Undecided Leaning toward What else do you need to make your decision? Check the facts 1.
It's all right not to choose surgery if I've only had one mild gallstone attack.
2.
Having surgery is the best way to get rid of my gallstones.
3.
I could be putting my future health in danger if I have my gallbladder removed.
Decide what's next 1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty 1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. 3.
Use the following space to list questions, concerns, and next steps. Your Summary Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Your decision |
| Author | Monica Rhodes |
| Editor | Kathleen M. Ariss, MS |
| Associate Editor | Pat Truman, MATC |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology |
Gallstones: Should I have gallbladder surgery?
- Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the Facts
Your options
- Have surgery to remove your gallbladder.
- Don't have surgery. Wait and see if you have another attack.
Key points to remember
- If you feel comfortable managing mild and infrequent gallstone attacks, and if your doctor thinks that you aren't likely to have serious complications, it's okay not to have surgery.
- Most doctors recommend surgery if you have had repeated attacks. If you have had one attack of gallstone pain, you may want to wait to see whether you have more.
- Surgery is the best way to prevent gallstone attacks. The surgery is very common, so doctors have a lot of experience with it.
- Your body will work fine without a gallbladder. There may be small changes in how you digest food, but you probably won't notice them.
What are gallstones?
Gallstones are stones made of cholesterol and other things found in bile. They form in the gallbladder or bile duct. They may be as small as a grain of sand or as large as a golf ball.
Most people with gallstones have no symptoms and don't need treatment. Those who do have symptoms often have surgery to remove the gallbladder.
In people who do have symptoms, the most common one is pain in the upper right area of your belly. Often the pain feels like it's in the upper belly, especially on the right side. Other symptoms include nausea and vomiting.
Symptoms usually don't come back after the gallbladder has been removed.
If gallstones block a duct, you may get jaundice. Jaundice makes your skin and the whites of your eyes yellow. It can also cause dark urine and light-colored stools.
What is the surgery to remove the gallbladder?
Laparoscopic gallbladder surgery is the most common surgery done to remove the gallbladder. The doctor inserts a lighted viewing instrument called a laparoscope and surgical tools into your belly through several small cuts. This type of surgery is very safe. People who have it usually recover enough in 7 to 10 days to go back to work or to their normal routine.
Laparoscopic surgery does not remove stones in the common bile duct.
Open gallbladder surgery involves taking the gallbladder out through one larger incision in your belly. Open surgery may be done if laparoscopic surgery is not an option or when problems are found during laparoscopic surgery. The hospital stay is longer with open surgery.
Stones in the bile duct
If gallstones are found in the common bile duct before or during surgery to remove the gallbladder, a doctor may do a procedure called an ERCP. This involves putting a tube called an endoscope down your throat to your small intestine. The doctor uses the scope to look for stones in the duct and remove them.
What are the risks of gallbladder surgery?
The overall risk from laparoscopic gallbladder surgery is very low. The most serious risks include:
- Infection.
- Bleeding.
- Injury to the common bile duct.
- Injury to the small intestine by one of the tools used during surgery.
- Risks of general anesthesia.
Risks from open gallbladder surgery include:
- Injury to the common bile duct.
- Bleeding.
- Infection.
- Injuries to the liver, intestines, or major blood vessels in the belly.
- Blood clots or pneumonia related to the longer recovery period after open surgery.
- Risks of general anesthesia.
Postcholecystectomy syndrome
After gallbladder surgery (cholecystectomy), a few people have ongoing symptoms, such as belly pain, bloating, gas, or diarrhea. This is called postcholecystectomy syndrome. These symptoms can be treated with medicines.
What are the risks of NOT having the gallbladder removed?
There is little risk in not having surgery if you have only one mild attack. But if you have more than one painful attack, you're likely to have more in the future.
The risks of not treating gallstones may include:
- Unpredictable attacks of gallstone pain.
- Episodes of inflammation or serious infection of the gallbladder, bile ducts, or pancreas.
- Jaundice and other symptoms caused by blockage of the common bile duct. Jaundice makes your skin and the whites of your eyes yellow. It can also cause dark urine and light-colored stools.
About 1 out of 3 people with gallstones who have a single attack of pain or other symptoms do not have symptoms again.1 That means that 2 out of 3 people do have another attack.
If you decide against surgery, what can you do to prevent another attack?
You may be able to prevent gallstone attacks if you:
- Stay close to a healthy weight by eating a balanced diet and getting regular exercise.
- Avoid rapid weight loss. When you lose weight by dieting and then you gain weight back again, you increase your risk of gallstones, especially if you are a woman. If you need to lose weight, do it slowly and sensibly.
About 1 out of 3 people with gallstones who have a single attack of pain or other symptoms do not have symptoms again.1 That means that 2 out of 3 people do have another attack.
Why might your doctor recommend gallbladder surgery?
Your doctor may recommend surgery if:
- You have repeated gallstone attacks.
- The pain from the attacks is severe.
- You have complications, such as inflammation of the gallbladder or the pancreas.
- You have an impaired immune system.
2. Compare Options
| Have gallbladder surgery | Don't have surgery | |
|---|---|---|
| What is usually involved? |
|
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| What are the benefits? |
|
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| What are the risks and side effects? |
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Personal stories
Are you interested in what others decided to do? Many people have faced this decision. These personal stories may help you decide.
If you need more information, see the topic Gallstones.
Personal stories about gallbladder surgery for gallstones
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
" I have had a couple of gallbladder attacks over the past few years. They weren't too bad, but I did take a sick day or two each time. Because I travel several times a month for work, I have decided to have my gallbladder removed. That way I won't have to worry about having an attack while I am away on business, possibly even out of the country. "
— Kelly, age 43
" When I was pregnant, my doctor discovered that I have gallstones. We talked it over, and it turns out that it's possible that the stomach pain I had a couple of years ago might have been related to my gallstones. I haven't had any problems since then, so we agreed to wait and see if I have another attack. If I do, we can do some tests and find out if the pain is caused by the gallstones. I don't want to have surgery if there is no need. "
— Jackie, age 37
" My first gallstone attack was pretty painful. I know I could handle another attack if it happens, but I would just as soon have surgery and know that I won't have another one. "
— Mike, age 50
" My gallbladder attacks have been pretty mild so far, and I've only had two in the past 5 years. I'm not too concerned about it. My doctor told me the signs of a more serious problem, so I feel well-prepared for another one, if it happens. We agree that I don't need surgery now. "
— Carmen, age 50
3. Your Feelings
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have gallbladder surgery
Reasons not to have gallbladder surgery
The pain from my gallstone attacks is very bad.
I have had one or more gallstone attacks, but they don't hurt much.
The thought of having more attacks is worse than the thought of having surgery.
I want to avoid surgery if I possibly can.
I do a lot of traveling to places where I may not be able to get help if I have a serious attack.
I'm never too far away from medical treatment.
Cost is not an issue for me.
I'm not sure I can afford to have surgery.
My other important reasons:
My other important reasons:
4. Your Decision
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having gallbladder surgery
NOT having gallbladder surgery
5. Quiz Yourself
Check the facts
1. It's all right not to choose surgery if I've only had one mild gallstone attack.
- True
- False
- I'm not sure
2. Having surgery is the best way to get rid of my gallstones.
- True
- False
- I'm not sure
3. I could be putting my future health in danger if I have my gallbladder removed.
- True
- False
- I'm not sure
Decide what's next
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
- I'm ready to take action.
- I want to discuss the options with others.
- I want to learn more about my options.
3. Use the following space to list questions, concerns, and next steps.
| Author | Monica Rhodes |
| Editor | Kathleen M. Ariss, MS |
| Associate Editor | Pat Truman, MATC |
| Primary Medical Reviewer | Kathleen Romito, MD - Family Medicine |
| Specialist Medical Reviewer | Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology |
Last Updated:March 16, 2009
Author:Monica Rhodes
Medical Review:Kathleen Romito, MD - Family Medicine & Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
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