Gallbladder removal

What is gallbladder removal?

Gallbladder removal, or cholecystectomy, is an operation to take out the gallbladder, the small organ under the liver that stores bile. It is advised when gallstones cause pain, inflammation or complications. It is usually done by keyhole surgery, and the body adapts well without the gallbladder.

The gallbladder stores bile made by the liver. Stones can form inside and block the flow, causing attacks of pain, infection, or jaundice. Removing the gallbladder stops the stones forming again and resolves the symptoms in most people whose pain is clearly related to gallstones.

Why might the gallbladder need to be removed?

Gallbladder removal is advised when gallstones block the flow of bile and cause repeated attacks of pain, inflammation of the gallbladder, jaundice or inflammation of the pancreas. Removing the gallbladder stops new stones forming. Dr Wong first confirms that your symptoms are coming from the gallbladder.

• Gallstones blocking the duct
• Inflammation of the gallbladder
• Stones causing jaundice or pancreas inflammation
• Repeated attacks of biliary pain

What are the symptoms of gallstones?

Gallstone symptoms include pain in the upper right or middle of the abdomen, often after fatty meals and sometimes reaching the back, with nausea and bloating. Fever suggests inflammation, and yellow skin or dark urine suggests a blocked duct. Many people with gallstones have no symptoms.

• Pain in the upper right or centre of the abdomen
• Pain after fatty meals, sometimes reaching the back
• Nausea and bloating
• Fever during inflammation
• Yellow skin or dark urine if a duct is blocked

When should I see a colorectal surgeon?

Gallstone pain with fever, yellowing of the eyes or skin, severe vomiting, pale stools with dark urine, or severe constant abdominal pain needs urgent medical help. These can mean infection, a blocked bile duct or pancreatitis, and they should not wait for a routine appointment.

The warning signs below need prompt attention.

• Fever with constant pain
• Yellowing of the eyes
• Severe vomiting
• Pale stools and dark urine
• Inflammation of the pancreas

How are gallstones diagnosed?

Gallstones are usually diagnosed with an ultrasound of the abdomen and liver blood tests. MRCP or other imaging is added if a stone in the bile duct is suspected. Dr Wong also checks that your symptoms match the findings, because stones alone do not always need surgery.

• Ultrasound of the abdomen
• Liver blood tests
• MRCP or other imaging if a duct stone is suspected
• Assessment of symptoms

How is the gallbladder removed?

Gallbladder removal is usually done by laparoscopic keyhole surgery through small cuts. Dr Wong changes to open surgery if keyhole is not safe, and clears the bile duct when stones are there. Antibiotics treat an acute infection, and diet advice is given before surgery.

• Laparoscopic cholecystectomy
• Open surgery if keyhole is not safe
• Bile duct clearance when needed
• Antibiotics for acute infection
• Diet advice before surgery

What are the risks and complications?

The risks of gallbladder removal are uncommon. They include bleeding, infection, bile leakage, injury to the bile duct, retained stones, and anaesthesia and blood clot risks. Bile duct injury is rare.

• Bleeding and infection
• Bile leakage
• Injury to the bile duct
• Rare retained stones
• Anaesthesia and blood clot risks