Surgery for gallstones

The first keyhole operation for gallstones (laparoscopic cholecystectomy) was performed in France in 1987. This has now become very routine surgery and the vast majority of gallbladder surgery is now performed laparoscopically.

Gallstones are extremely common and may or may not cause symptoms. When they do the main symptom is pain, often after food, which can be severe. It usually occurs in the right upper side of the abdomen and often goes around to the back. It can last from a few minutes to several hours and may be associated with vomiting. The pain often makes patients very restless. Other symptoms include non-specific indigestion, jaundice and sometimes an attack of pancreatitis can be the first manifestation of the problem

The diagnosis may be obvious to your doctor on the story alone. He will need to arrange an ultrasound scan to confirm the diagnosis. If you have been jaundiced you will need to have some blood tests and a special type of scan to see whether any stones have escaped from the gallbladder into the bile duct (a tube leading from the liver to the intestine). You may need to have any stones in the bile duct removed before your operation by a special type of endoscopy called an ERCP.

If your doctor determines that you need surgery you will be offered a keyhole operation although there is a small chance (normally<5%) that this will not prove to be possible. The operation is carried out under general anaesthetic and lasts for about 1 hour. You will have 4 cuts, the largest of which will be only 1cm in length. The entire gallbladder and stones within it are removed through one of the tiny incisions. You will normally be able to go home the same or the following day and there need be no restrictions on your activity after the operation. Most patients are ready to go back to work around 14 days after the operation.

Complications are unusual but can occur. Damage to the bile duct is a rare but serious complication (0.05%). Collections of fluid can accumulate where the gallbladder used to be and these can cause discomfort. They usually settle down without treatment but occasionally need draining. Other complications such as bleeding and wound infection can occur but are rare events.

As with any keyhole operation it is important for you to be sure that your surgeon has adequate experience of the technique of laparoscopic cholecystectomy.

For more information please visit our 'Patient Information' page where you can download information sheets relating to the specific operations.