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
                
                
                
                  
                    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.
 
                  
                    FAQs
                    
                      
                      
                        
                           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. 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: 
                          
                            - Infection.
- Bleeding.
- 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.
- 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.
Both surgeries have the 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. 
                         
                       
                     
                    
                      
                      
                        
                          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.footnote 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? | 
                                  
 
 
 
 
 
 
 
 | 
                                 | 
                          
                          
                            
                              Have gallbladder surgery
                              Have gallbladder surgery
                              
                                
                                  - 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.
 
                             
                            
                              Don't have surgery
                              Don't have surgery
                              
                                
                                  - 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.
 
                             
                           
                         
                       
                     
                   
                  
                    
                      
                        
                          
                          
                            
                              
                                
                                   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. 
                                 
                                
                               
                              
                                
                                   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. 
                                 
                                
                               
                              
                                
                                   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. 
                                 
                                
                               
                              
                                
                                   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. 
                                 
                                
                               
                             
                           
                          
                         
                       
                     
                   
                 
               
              
                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?
                
                
                
                  
                    
                      
                        
                          
                          
                            
                              
                             
                            
                              
                             
                            
                              
                             
                           
                         
                        
                          
                          
                            
                              
                             
                            
                              
                             
                            
                              
                             
                           
                         
                        
                          
                          
                            
                              
                                
                                  
                                    
                                      
                                        1.
      
                                        How sure do you feel right now about your decision?
                                      
                                      
                                      
                                     
                                    
                                    
                                      Not sure at all
                                      Somewhat sure
                                      Very sure
                                      
                                      
                                     
                                    
                                    
                                   
                                 
                               
                             
                            
                              
                             
                            
                              
                                
                                
                              
                             
                           
                         
                       
                     
                   
                 
               
              
                Your Summary
                
                
                
                  Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
                  
                    
                      
                      
                        
                          
Next steps
                        
                        
                        
                        
                          
Which way you're leaning
                        
                        
                        
                        
                          
How sure you are
                        
                        
                        
                        
                          
Your comments
                        
                        
                       
                     
                    
                      
                      
                        
                          
Key concepts that you understood
                        
                        
                        
                        
                          
Key concepts that may need review
                        
                        
                        
                       
                     
                    
                    
                   
                 
               
             
            
            
              
                
                
                  Credits
                  
                    
                      | Author | Ignite Healthwise, LLC Staff | 
                    
                      | Clinical Review Board | Clinical Review Board All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
 | 
                  
                  
                  
                    References
                    Citations
                    
                      
                        - 
                          
                          Wang DQH, Afdhal NH (2010). Gallstone disease. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., vol. 1 , pp. 1089–1120. Philadelphia: Saunders.
 
                   
                 
               
             
           
          
            
              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?
              Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
              
                
                  - 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.
 
                
                  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. 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.
                       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. 
                     
                   
                  
                    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 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.
Both surgeries have the 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. 
 
                   
                  
                    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 your options
                
                  
                    
                      |  | Have gallbladder surgery | Don't have surgery | 
                    
                      | What is usually involved? | 
                          
                            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. | 
                          
                            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. | 
                    
                      | What are the benefits? | 
                          
                            Surgery gets rid of the gallstones and usually keeps them from coming back.The surgery is safe and is very common. | 
                          
                            You avoid any costs and risks of surgery. | 
                    
                      | What are the risks and side effects? | 
                          
                            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 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
                  
                    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."
                       
                      
                     
                    
                      
                        "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."
                       
                      
                     
                    
                      
                        "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."
                       
                      
                     
                    
                      
                        "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."
                       
                      
                     
                   
                 
               
              
                3. 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
                     
                    
                    
                   
                 
               
              
              
              
                4. 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
                   
                  
                  
                 
               
              
                5. 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.
                        
                        
                        
                        
                          You'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.
                        
                       
                     
                    
                      
                        2.
        Having surgery is the best way to get rid of my gallstones.
                        
                        
                        
                        
                          That's right. Surgery gets rid of the gallstones and usually keeps them from coming back. The surgery is safe and widely done.
                        
                       
                     
                    
                      
                        3.
        I could be putting my future health in danger if I have my gallbladder removed.
                        
                        
                        
                        
                          Correct. 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
                  
                    
                      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.
                        
                        
                        
                       
                     
                    
                      
                        
                        
                       
                     
                   
                 
               
              
                
                  Credits
                  
                    
                      | By | Ignite Healthwise, LLC Staff | 
                    
                      | Clinical Review Board | Clinical Review Board All Ignite Healthwise, LLC education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
 | 
                  
                  
                  
                    References
                    Citations
                    
                      
                        - 
                          
                          Wang DQH, Afdhal NH (2010). Gallstone disease. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., vol. 1 , pp. 1089–1120. Philadelphia: Saunders.
 
                   
                 
               
              
                
                Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
              
             
           
         
        
        
          
            
              Current as of: July 31, 2024
           
          
         
        
          Wang DQH, Afdhal NH (2010). Gallstone disease. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., vol. 1 , pp. 1089–1120. Philadelphia: Saunders.