Your treatment plan for gallstones depends on how your symptoms are affecting you.
You may not have any treatment if you do not have symptoms. But tell your GP if you get symptoms.
Why you may have treatment
You may need treatment if you have gallstones and a condition that increases your risk of complications.
These include:
- scarring of the liver (cirrhosis)
- high blood pressure inside the liver - this is called portal hypertension and is often linked to alcohol-related liver disease
- diabetes
Sometimes a scan can show high levels of calcium in your gallbladder. If this is the case, your GP may recommend treatment. It can lead to gallbladder cancer in later life.
If you have a lot of abdominal pain (biliary colic), treatment depends on how the pain affects your daily life.
If the pain is mild and does not happen often, your GP may give you painkillers. They will also talk to you about your diet and how healthy eating can help control the pain.
Some people have bloating and diarrhoea after eating fatty or spicy food. Try to avoid foods that trigger symptoms.
You may have surgery to remove your gallbladder if your symptoms are more severe.
The gallbladder is not an essential organ. You can lead a normal life without it.
Keyhole surgery to remove your gallbladder
You will usually have keyhole surgery to remove your gallbladder. This is sometimes called a laparoscopic cholecystectomy.
There are risks involved with every surgery. Your surgeon will tell you these risks and about the risks linked to a laparoscopic cholecystectomy.
Before keyhole surgery
The surgery is usually done under general anaesthetic. This means you are asleep during the procedure. You will not feel any pain.
The operation takes 60 to 90 minutes.
During keyhole surgery
The surgeon makes 3 or 4 small incisions (cuts) in your abdomen (tummy). You will have 1 larger incision near your belly button - about 2cm to 3cm long. The others will be on the right hand side of your tummy.
The surgeon will inflate your tummy using carbon dioxide gas. This is harmless. It makes it easier for the surgeon to see your organs. You can have some discomfort or pain in your shoulder after surgery if carbon dioxide is used.
Your surgeon will insert a laparoscope through 1 of the cuts in your abdomen. A laparoscope is a long thin tube with a tiny light and video camera. This lets your surgeon view the operation on a screen as they work. They remove your gallbladder using small surgical instruments.
Your surgeon may also do an x-ray or an ultrasound scan of the bile duct to check for gallstones. If there are any, the surgeon may remove them.
After keyhole surgery
You usually stay in hospital for 1 to 2 days after surgery. It takes about 10 days to recover.
Open surgery to remove the gallbladder
You may have open surgery if keyhole surgery is not possible. You might also need open surgery if an unexpected complication happens.
Your doctor may advise you against having keyhole surgery if you:
- are in the third trimester (last 3 months) of pregnancy
- have a lot of extra weight or obesity
- have an unusual gallbladder or bile duct structure that makes keyhole surgery difficult
Open surgery to remove the gallbladder is sometimes called an open cholecystectomy.
How open surgery is done
The operation is done under general anaesthetic. This means you are asleep and will not feel any pain. Your surgeon makes a 10cm to 15cm incision (cut) in your tummy underneath the ribs. They remove the gallbladder through this incision.
After open surgery
Open surgery is as effective as keyhole surgery. But it has a longer recovery time. It causes more visible scarring.
Most people stay in hospital for up to 5 days after the surgery. It can take 6 weeks to recover.
Endoscopic retrograde cholangio-pancreatography (ERCP)
ERCP is a procedure to remove gallstones from the bile duct.
The gallbladder is not removed during the procedure.
Any gallstones in the gallbladder will stay there unless they are removed using other surgical techniques.
ERCP is like a diagnostic cholangiography. This is where an endoscope (a long, thin flexible tube with a camera) is passed through your mouth. It goes down to where the bile duct opens into the small intestine.
During an ERCP
The surgeon widens the opening of the bile duct. They do this by making a small cut or using a heated wire. The gallstones are then removed or left to pass into your intestine and out of your body.
Sometimes a small tube called a stent is put in the bile duct. This helps the bile and gallstones to pass.
You are usually given sedation for an ERCP. This means you are awake during the procedure. But you will not have any pain.
After ERCP
The ERCP can take 15 to 60 minutes. But it usually takes about 30 minutes. You may need to stay overnight in hospital after the procedure. This is so doctors and nurses can check you are okay.
Treatment with medicines
If your gallstones are small and do not contain calcium, it is possible to take medicine to dissolve them.
You will need a specialist prescription from your doctor.
It is not a common treatment because:
- it is rarely very effective
- you need to take it for up to 2 years
- gallstones can come back once you stop treatment
Diet and gallstones
A healthy diet will not cure gallstones or get rid of your symptoms completely. But it can improve your general health and help control pain caused by gallstones.
