Gallstones: symptoms, and why keyhole surgery is the usual treatment

The gallbladder is a small pouch under the liver that stores bile, a fluid that helps digest fat. Gallstones form when substances in bile harden into stones. They are very common, and many people have them without knowing.

Common symptoms

• Pain in the upper right or middle of the abdomen, often after oily or heavy meals
• Pain that spreads to the back or right shoulder
• Nausea, vomiting, bloating and indigestion
• Fever with pain, which can mean the gallbladder is infected
• Yellowing of the eyes or skin, which can mean a stone has blocked the bile duct

Fever, yellowing of the eyes or severe pain that does not settle need urgent medical attention.

How gallstones are diagnosed

An ultrasound of the abdomen is the main test. Blood tests check the liver and look for signs of infection.

Do gallstones need surgery?

Stones that cause no symptoms may only need watching. Once gallstones cause pain or infection, attacks usually come back and can lead to complications such as pancreatitis. The standard, lasting treatment is to remove the gallbladder. Medicines do not reliably dissolve stones.

Laparoscopic gallbladder removal

The operation, called laparoscopic cholecystectomy, is done through three or four small cuts using a camera. The body manages well without a gallbladder: bile simply flows directly from the liver into the intestine.

• Less pain than open surgery
• Small scars
• Most patients go home within a day or two
• Return to light activity within about a week