The Essential Guide to Gallstones and Keyhole Surgery

What are the Symptoms?

Gallstones often cause no symptoms at all, but when they do, they typically cause sudden, severe pain in the upper right part of the abdomen or just below the breastbone. This pain can last for several hours and may radiate to the back or right shoulder. Other symptoms include nausea, vomiting and digestive discomfort, especially after eating fatty meals.

If gallstones block the bile ducts, they can lead to serious complications such as infection, inflammation of the gallbladder (cholecystitis) or jaundice. Less commonly, untreated gallstones can cause pancreatitis, which is a potentially life-threatening condition.

This is why the NICE (National Institute for Health and Care Excellence) guidelines recommend removal of the gallbladder as soon as is practicable for anyone with symptomatic gallbladder stones, with a further recommendation that this is carried out through keyhole surgery in a day-case setting where appropriate.

If gallstones have moved into the bile duct, then ERCP (endoscopic retrograde cholangiopancreatography) may also be recommended.

Who Is at Risk of Developing Gallstones?

Gallstones can affect anyone,
but some people are more likely to develop them than others.
You are at higher risk if you’re:

Female – Women are more prone to gallstones because oestrogen increases cholesterol levels in bile and can slow gallbladder emptying. Pregnancy, hormone therapy and birth control pills all raise oestrogen levels, which adds to the risk.

Age over 40 – As we age the balance of bile components changes, and the gallbladder may not empty as efficiently, making stone formation more likely.

Overweight or obese – Excess body weight can increase cholesterol in bile, which is one of the main contributors to gallstone formation.

Experiencing rapid weight loss – Losing weight too quickly can cause the liver to release extra cholesterol into bile, which can lead to gallstones.

High-fat, low-fibre diet – Diets rich in fat and low in fibre can alter bile composition and slow digestion, increasing the risk of stones.

Medical conditions – Conditions like diabetes, liver disease and certain blood disorders can affect bile chemistry or gallbladder function, making stones more likely.

Family history – Genetics play a role; if gallstones run in your family, you may inherit a tendency to develop them.

How Are Gallstones Diagnosed?

Gallstones are often discovered by chance during scans for other health issues, as many people have no symptoms. If you do have symptoms, ultrasound scans are the most common and reliable way to detect gallstones. You may also have blood tests to check liver function and look for signs of infection or blockage. In some cases, further imaging such as a specialised MRI scan (MRCP) or an endoscopic procedure may be needed if stones are suspected in the bile ducts.

How Quickly Can You Get Back to Normal?

You can eat and drink normally once you feel ready and there’s no need to maintain a low-fat diet.

Most people can shower the following day and are able to return to work within two weeks, but this depends on the type of job you do. If your work involves heavy lifting, you may need a little longer.

You can usually start driving again when you feel comfortable performing an emergency stop without pain.

A follow-up appointment is typically scheduled around six weeks after surgery.
 

Possible Side Effects and Risks

The body usually adapts well to living without a gallbladder, allowing you to maintain your usual lifestyle. Some patients may notice temporary digestive changes, such as looser stools, while the body adjusts. These effects are generally mild and short-lived, but can be medically treated if persistent.

Serious complications are extremely rare but can include infection, bleeding or injury surrounding structures. The most significant risk is damage to the common bile duct, where risk is quoted at 0.3-0.6%.