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Gallstones: 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
- 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.
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. 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.
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.
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 (endoscopic retrograde cholangiopancreatogram). 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.
The overall risk from laparoscopic gallbladder surgery is very low. The most serious risks include:
- Injury to the common bile duct.
- Injury to the small intestine by one of the tools used during surgery.
Risks from open gallbladder surgery include:
- Injury to the common bile duct.
- 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.
Both surgeries have the risks of general anesthesia.
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.
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.
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.
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.
Compare your options
What is usually involved?
What are the benefits?
What are the risks and side effects?
- You are asleep during surgery.
- You may go home the same day, or you may stay in the hospital for a day or two. If you have open surgery, your hospital stay will be longer.
- You can return to your normal activities within a week to 10 days. If you have open surgery, it will take 4 to 6 weeks.
- Surgery gets rid of the gallstones and usually keeps them from coming back.
- The surgery is safe and is very common.
- All surgery has risks, including bleeding and infection. Your age and your health also can affect your risk.
- Risk from laparoscopic surgery is very low. Possible problems include injury to the common bile duct or the small intestine.
- After surgery, a few people have ongoing symptoms, called postcholecystectomy syndrome.
- You try to prevent another attack by eating a balanced diet and getting regular exercise to stay close to a healthy weight.
- You avoid losing weight too quickly.
- You avoid any costs and risks of surgery.
- You may have more gallstone attacks.
- You may have episodes of inflammation or infection of the gallbladder, bile ducts, or pancreas.
- You may have jaundice and other symptoms caused by blockage of the common bile duct.
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
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.
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:
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
What else do you need to make your decision?
Check the facts
It's all right not to choose surgery if I've only had one mild gallstone attack.
- TrueYou're right. It's okay not to have surgery if you feel you can manage mild and infrequent attacks and if your doctor thinks you're not likely to have serious problems.
- FalseSorry, that's not right. It's okay not to have surgery if you feel you can manage mild and infrequent attacks and if your doctor thinks you're not likely to have serious problems.
- I'm not sureIt may help to go back and read "Get the Facts." There are certain cases where it's okay not to have surgery.
Having surgery is the best way to get rid of my gallstones.
- TrueThat's right. Surgery gets rid of the gallstones and usually keeps them from coming back. The surgery is safe and widely done.
- FalseSorry, that's wrong. Surgery gets rid of the gallstones and usually keeps them from coming back. The surgery is safe and widely done.
- I'm not sureIt may help to go back and read the "Compare your options" chart. Surgery gets rid of the gallstones and usually keeps them from coming back. The surgery is safe and widely done.
I could be putting my future health in danger if I have my gallbladder removed.
- TrueNo, that's wrong. 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.
- FalseCorrect. 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.
- I'm not sureIt may help to go back and read "Get the Facts." 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.
Decide what's next
Do you understand the options available to you?
Are you clear about which benefits and side effects matter most to you?
Do you have enough support and advice from others to make a choice?
How sure do you feel right now about your decision?
Use the following space to list questions, concerns, and next steps.
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Arvydas D. Vanagunas, MD - Gastroenterology|