What are the benefits?

You should be free of pain and able to eat a normal diet. Surgery should also prevent the serious complications that gallstones can cause.

Are there any alternatives?

The gallstones can be left alone but this may lead to complications later. Surgery is suggested as it is the only dependable way to cure the condition.

It is possible to dissolve the stones or even shatter them into small pieces but these techniques involve unpleasant drugs that have side effects and a high failure rate. Antibiotics can be used to treat any infection of your gallbladder. Eating a diet low in fat may help to prevent attacks of pain.

What will happen if I decide not to have the procedure or the procedure is delayed?

Your gallstones may not cause any symptoms. If you have already had symptoms, it is likely that these will continue from time to time. There is a small risk of life-threatening complications.

If you develop any of the following symptoms, contact your healthcare team:

• Jaundice (yellow discolouration of the whites of the eyes, pale stools and dark urine).
• Constant, severe abdominal pain that does not get better after several hours.
• High temperature.

What does the procedure involve?

The procedure is performed under a general anaesthetic and usually takes about an hour. Your surgeon will use laparoscopic (keyhole) surgery as this is associated with less pain, less scarring and a faster return to normal activities. They will make several small cuts on your abdomen so they can insert tubes (ports) into your abdomen. Your surgeon will insert surgical instruments through the ports along with a telescope so they can see inside your abdomen and perform the procedure.

Your surgeon will remove your gallbladder from your abdomen through one of the ports.

How can I prepare myself for the procedure ?

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.

Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight. Your surgeon may suggest you follow a special diet for the 2 weeks before the procedure to reduce the size of your liver. The liver is a large organ that needs to be lifted to perform the surgery safely. If it is smaller, the risk of complications such as bleeding are reduced.

Regular exercise should help you prepare for the procedure, help you recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you may need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

What complications can happen?

The healthcare team are trained to reduce the risk of complications.

Any risk rates given are taken from studies of people who have had this procedure. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, have other health problems or you smoke. Health problems include diabetes, heart disease or lung disease.

Possible complications of this procedure are shown below. Some can be serious and may even cause death.

General complications of any procedure

• Bleeding
• Developing a hernia in the scar
• Infection of the surgical site (wound)
• Venous thromboembolism (VTE). This is a blood clot in your leg or one that has moved to your lung
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of Covid-19 (coronavirus) symptoms for at least 7 weeks before the procedure

Specific complications of this procedure

Keyhole surgery complications

• damage to structures such as your bowel, liver or blood vessels. The risk is higher if you have had previous surgery to your abdomen. About 1 in 3 of these injuries is not obvious until after the procedure
• developing a hernia near one of the cuts used to insert the ports
• surgical emphysema (a crackling sensation in your skin caused by trapped carbon dioxide)
• gas embolism. This is when gas (carbon dioxide) gets into the bloodstream and blocks a blood vessel
• conversion to open surgery

Cholecystectomy complications

• leaking of bile or stones
• retained stones in your common bile duct
• continued pain
• needing to go to the toilet more often. You may get diarrhoea
• inflammation of the lining of your abdomen (peritonitis)
• bile duct injury (narrowing or blockage), which is potentially serious
• allergic reaction to the equipment, materials, medication or dye. Sometimes the reaction can be serious or even life-threatening
• bowel injury, if your bowel is stuck to your gallbladder
• pancreatitis, if a stone moves into your common bile duct
• serious damage to your liver or its associated blood vessels
• tissues can join together in an abnormal way (adhesions)

Consequences of this procedure

• pain
• scarring of your skin, which can be unsightly

What happens after the procedure?

You should be able to go home the same day. However, your doctor may recommend that you stay in hospital a little longer.

You should be able to return to work after 2 to 4 weeks, depending on how much surgery you need and your type of work.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

You should make a full recovery and be able to return to normal activities and eat a normal diet.

Summary

Gallstones are a common problem. A procedure to remove your gallbladder should result in you being free of pain and able to eat a normal diet.

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