Keyhole Surgery to Remove Gallbladder and Gallstones
What is a gallbladder?
The gallbladder is a small organ that is attached to your liver. It is in the top right-hand corner of your tummy, just behind your lower ribs.
What does the gallbladder do?
The gallbladder stores a fluid called bile. Bile is necessary for digestion. When you eat, the gallbladder squeezes bile into the intestine to help digest food.
What are gallstones?
Gallstones are formed when bile in the gallbladder forms into solid material.
Why did I get gallstones?
Gallstones are very common and develop due to many reasons. Gallstones are more common in women, older people and people who are overweight.
What problems can gallstones cause?
Most people with gallstones do not get any problems from them. If gallstones are not causing problems we leave them alone.
Gallstones can cause a number of issues:
• Pain. Usually in the upper right hand corner of the tummy. This is often caused by eating something fatty. This is called biliary colic.
- Infection and inflammation of the gallbladder. This causes pain and makes you feel unwell and feverish. This is called cholecystitis.
- Jaundice. Your skin and the whites of your eyes turn yellow. This occurs when gallstones causes blockage to a tube called the bile duct.
- Acute pancreatitis. Gallstones can cause inflammation of your pancreas gland. This causes severe pain in your tummy. This can cause serious, life-threatening problems.
What are the options for managing gallstones?
The most effective way of treating the symptoms is to remove the gallbladder and gallstones with an operation.
Some people try to avoid the pain from gallstones by following a low-fat diet. This is not always effective. If you have experienced symptoms from gallstones you are highly likely to get symptoms again.
It is possible to get rid of gallstones by taking tablets or breaking them up with shockwaves. These treatments are not usually used in the U.K. as they have side effects and the gallstones often come back again.
What does gallbladder removal surgery involve?
You will have a general anaesthetic (be put to sleep). The operation is usually done with keyhole surgery (called a laparoscopic cholecystectomy). The surgeon will make 3 or 4 small cuts (1.5cm or less) on your tummy (one in the belly-button, one under your breast bone and two under your ribs on the right hand side). A camera and long thin instruments are put into the tummy to separate the gallbladder from the liver.
How long does the operation take?
The procedure normally takes 30 – 60 minutes. The operation may take longer if the gallbladder is very inflamed. You may have to wait a few hours for your procedure. You will spend several hours in hospital recovering from the operation. In total, you can expect to spend most of the day in hospital.
I heard surgery might be done with a robot, what is the difference?
Your operation may be performed using a surgical robot. This means that surgical instruments (normally held by a surgeon) will be held by a robotic device. Your surgeon will control the movement of these instruments from a console or computer next to the operating table.
Your operation will still be performed with keyhole surgery. This should not affect your recovery or the success of the operation. Your surgeon will tell you in advance if they plan to do your operation robotically.
How long will I stay in hospital?
Most people who have keyhole gallbladder surgery will go home the same day as their operation. Occasionally you may need to stay in hospital after your operation. For most people this will involve a one-night stay in hospital.
Can I live normally after having my gallbladder removed?
Yes, most people notice no difference after a gallbladder operation. There are no dietary restrictions once your gallbladder has been removed. Occasionally patients report altered bowel function after surgery.
Are there any complications of gallbladder removal surgery?
Gallbladder removal is generally safe. Possible risks include:
- Damage to a blood vessel or bowel: This is rare (1 in 200 operations). This is usually recognised at the time of operation and can be fixed. Rarely, damage is not seen at the time of the operation, and a second operation within days of the original operation is required to deal with it.
- Damage to the bile duct: This is rare (1 in 300 operations). This is a very serious complication. This requires a special endoscopy test called an ERCP and/or major abdominal surgery to fix.
- Bile leak: This is rare (occurs in around 1 in 200 gallbladder operations). A collection of bile fluid can form inside your tummy after the operation. If your surgeon suspects a bile leak, they will carry out a further keyhole operation or a scan to inspect the inside of your tummy. If bile is present, you will require a procedure to drain bile from inside the tummy.
- Gallstones left behind in the bile duct: This is rare (occurs in around 1 in 200 gallbladder operations). It is possible that small gallstones may slip out of the gallbladder into the bile duct during your operation. If this happens, the gallstones could cause jaundice, pancreatitis or pain.. This can occur days, weeks or even months after your operation. This is usually dealt with by an ERCP procedure.
- Gallstones left behind in the tummy: Occasionally gallstones can spill into your tummy during the operation. Very rarely (less than 1 in 1000 chance) these “lost” stones can cause an infection months or years later. This may require treatment with antibiotics or even an operation to retrieve the gallstones.
- Post-operative diarrhoea: Some people may open their bowels more frequently after gallbladder surgery. We think this is due to a change in the circulation of bile acids or bile salts in the bowel. We suspect this happens in about 1 in 8 people who have a gallbladder operation. If diarrhoea becomes a problem after your operation, you may require investigation of your bowel including a colonoscopy and/or a scan. Diarrhoea can often be managed with changes to your diet and tablet medication.
- Ongoing symptoms: Some people continue to experience pain and other symptoms after gallbladder removal surgery. We call this post cholecystectomy syndrome. In some people it is not entirely clear why this happens. In some people there may be another problem inside the tummy causing symptoms similar to gallstones. We are very careful to make sure we offer surgery to people with symptoms that we think are due to gallstones. If you have ongoing symptoms after surgery you may require further tests such as a gastroscopy or a scan.
Are there any other complications of the operation and a general anaesthetic?
Most people who are fit and healthy do not experience any problems. Possible risks include:
- Wound infection. This is rare (occurs in around 1 in 100 patients). You are at higher risk if you are overweight, if you are a smoker and if you have diabetes.
- Blood clots in the legs and lungs. This is rare. Your risk is higher if you are overweight, a smoker, in poor general health, have difficulty walking, or have had a previous blood clot.
Can people die having gallbladder surgery?
Yes, but this is very, very rare. Surgeons and anaesthetists are careful not to operate on people where the risks of surgery outweigh the benefits. Overall, around one person out of a thousand having gallbladder surgery will die. This is usually due to a post-operative complication such as a heart attack. Your risk is higher if you are elderly or in poor health.
Will any other procedures be performed during my operation?
Possibly. These include:
- X-ray. We sometimes perform an X-ray during the operation to see if there are gallstones in the bile duct. This is called a cholangiogram.
- Open operation. If the gallbladder is very inflamed or there is a problem during the operation, it may not be possible to perform the operation with keyhole surgery. In this case we perform an open operation. This involves making a 10-20cm cut on your tummy. It is very unusual that we can’t remove your gallbladder with keyhole surgery (3 cases out of 100). If you have an open operation, your recovery will be longer than if you had keyhole surgery. You may have more pain and sickness. You will need to spend several days in hospital. Your recovery at home will be longer.
- Drain. If we are worried about collections of fluid forming inside your tummy after the operation, we sometimes leave a drain. This is a thin plastic tube that sticks out of one of your wounds. This is connected to a bag that collects the fluid. If a drain is used, it usually stays for one or two days after your operation. The drain is often removed on the ward with little discomfort. It is unusual for us to leave a drain.
- Abandon operation. Sometimes it may not be safe or possible to remove the gallbladder and gallstones. This is very rare.
Is there anything I can do to improve my health before having surgery?
- If you are a smoker, you should stop as far in advance of your surgery as possible (at least 6 weeks). More information can be found at www.nhs.uk/better-health/quit-smoking/
- If you are overweight, you should try and lose weight, and get down to your target weight for your height. More information can be found at www.nhs.uk/better-health/lose-weight/
- If you are obese, we may ask you to go on a liver reduction diet 2 to 3 weeks before your operation.
After Your Gallbladder Operation
What medications will I be sent home with?
Most patients will be sent home with painkillers, anti-sickness medication and laxatives. We will provide instruction on when and how to take these medications.
Will I have pain after my operation?
It is normal to feel tummy bloating, discomfort and shoulder pain for the first few days after your operation. Most people need to take painkillers for the first few days after their operation. You should take the painkillers to make you feel comfortable enough to be able to do light activities.
What do I do if I am struggling to open my bowels after the operation?
It is common to get constipated for the first few days after the operation. This is particularly common if you are taking strong painkillers such as codeine or tramadol. It is important to stay well hydrated and drink plenty of fluids. If you are taking strong painkillers, you should take a regular laxative alongside these. The hospital should send you home with a laxative called Macrogol. If not, a number of laxatives are available at your local pharmacy.
Will I need to have somebody to look after me at home?
Yes, after day-case surgery you must have a responsible adult able to stay with you for 24 hours. Many people feel tired and have some discomfort after surgery. It is helpful to have someone to help with cooking, chores and shopping until you are fully mobile
What should I do with my wounds?
Your wounds will be covered by a dressing. For the first couple of days, it is common to have slight blood leakage on to the dressing. The dressings are waterproof and you can shower with the dressings on. If your wound is clean and dry after 4 days you may have a shower with the dressings off (7 days for a bath). Extra dressings can be purchased at most chemists if you feel you need them.
How will I know if my wounds are healing properly?
Most wounds heal without problems. You do not need to visit your GP or practice nurse unless you think there is a problem. It is quite normal to experience some bruising where your wounds are. Occasionally a very large bruise may form which takes one or two weeks to go away. The wounds may ooze a little bit of blood for the first 48hrs, requiring a change of wound dressing. This is quite normal. If your wounds become hot, red, smelly, or weeps fluid requiring more than one dressing change a day, you should contact the hospital.
It is normal for a wound to feel hard and tender for several weeks. It is quite normal for you to feel a lump under the wound, as this is the healing ridge of tissue. The scar will look red, and often remains red for many months.
Will I need to have any stitches removed?
Most surgeons use skin stitches that do not require removal. We will tell you if you need stiches that need removal.
When will I be able to go back to work?
You can return to a desk job after 1 to 2 weeks. If you have a manual or physical job, you will require longer off work, around three to four weeks.
Please ask us for a fit note (Statement of Fitness for Work) on the day of your operation.
When can I start to drive again?
Once you can sit in your car and use all the controls without discomfort. You must not be taking strong painkillers. You must be able to perform an emergency stop. We usually recommend not driving for a week after keyhole surgery. It is always best to check with your insurance company to see if they have any specific rules related to the type of operation you have had done.
Will I be given a hospital appointment after my operation?
Most people will make a straightforward recovery We do not routinely see patients after a gallbladder operation. If you have problems your General Practitioner cannot solve, they will refer you back to see your surgeon.
For more information, visit the following websites
A short video describing the operation
More information about gallbladder surgery
More information about the recovery from gallbladder surgery
If you are experiencing any of the following symptoms, please contact your surgical team
- Unable to eat or drink.
- Severe pain
- Fever
- Feeling unwell
- Skin or eyes becoming yellow
- Wound problems
Contact information
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If your operation was at |
Call: 07770 730 220 07826 921 319 |
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If your operation was at |
Call: 07468 354 436 07826 921 319 |
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If your operation was at |
Call: |
If you cannot get in contact, please call 111 |
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If you feel seriously unwell, call 999 or go
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Heatherwood Hospital and Wexham Park Hospital 0300 615 3365
Title of Leaflet Laparoscopic Cholecystectomy
Author Iain Wilson, Consultant Upper GI Surgeon
Department Day Surgery Unit, Heatherwood
Ref. No Y/011/5
Issue Date October 2023
Review Date September 2024
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Please remember that this leaflet is intended as general information only. We aim to make the information as up to date and accurate as possible. Please therefore always check specific advice or any concerns you may have with your doctor.