Dear doctor, I have gallstones and am really nervous about having my gallbladder removed. Do I need surgery?

08 May 2018

Q: I have gallstones and have been advised I would need to have my gallbladder removed which really worries me. I’ve tried to cut out fatty foods, which has helped ease the bouts of pain. Do I need to have surgery?                          

A: I can understand that you are worried about surgery for your gallstones, this is natural. However, in the right patient, this is a very successful and safe keyhole operation that permanently cures the symptoms of gallstones and more importantly, avoids potentially more serious complications of gallstones in the future.

I’m pleased to hear you have tried to cut out fatty foods – this is a good idea and should prevent the more painful episodes of pain. If this diet works for you and you can maintain a low fat diet long-term, then this is certainly an option to avoid surgery. However, there are small risks with this strategy as in some patients the gallstones can cause more serious problems such as acute infection of the gallbladder, which could rarely lead to the gallbladder perforating. The gallstones could fall out of the gallbladder into the bile duct (tube between the liver and gut) causing a blockage. This will result in jaundice and there is also a risk of inflammation of the pancreas (acute pancreatitis). This unusual complication can be serious and life-threatening in 30% of patients. So you do need to discuss these with your surgeon and decide if you wish to take these risks or not.

Keyhole surgery has been the major advance in gallbladder surgery in the past 20 years. It is an established procedure often done as a day-case so you are home only a few hours after surgery with minimal pain. Your symptoms should resolve and you will be able to get back to physical work within two to three weeks. My patients often say that they have had their ‘life back’ and can enjoy a meal out with friends and family without worrying about pain.

Each case is individual and on some occasions, gallstones can seriously disrupt your family and work life. Should you decide to consider surgery I would recommend you see a specialist who will be able to discuss your suitability and the risks and benefits of surgery with you.

Find out more about Mr Simon Toh, Consultant General Surgeon practising at Spire Portsmouth Hospital.

The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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