Gallstone disease (Cholelithiasis)

Causes and Risk Factors

Gallstones form when bile contains too much cholesterol or bilirubin, or not enough bile salts, or when the gallbladder doesn’t empty properly.

You may be more at risk if you:

• Are overweight or losing weight quickly
• Are female, pregnant, or over 40
• Have diabetes
• Eat a high-fat, low-fibre diet
• Have a family history of gallstones
• Take certain medications (e.g. oestrogen therapy)
• Have had rapid weight loss after bariatric surgery

Symptoms

Gallstones often cause no symptoms, but can lead to:

• Sudden, intense pain in the upper abdomen (biliary colic), lasting minutes to hours
• Pain after eating, especially fatty meals
• Pain in the right shoulder or back
• Nausea or vomiting

Indigestion, bloating or gas

Signs of a complication:

• Fever and chills (possible infection)
• Yellowing of the skin or eyes (jaundice)

Dark urine or pale stools

Treatment Options (Surgery or Medications)

A. Surgery (Gold Standard)

• Laparoscopic cholecystectomy: Minimally invasive removal of the gallbladder — most common and definitive treatment.
• Open cholecystectomy: Rarely used; reserved for complications or anatomical difficulties.

B. Medications (For Those Who Can’t Have Surgery)

• Ursodeoxycholic acid (ursodiol): Dissolves cholesterol stones slowly — only works on small, non-calcified stones.
  • Takes months to years.
  • High recurrence if gallbladder is left in.

C. Endoscopic procedures

What is a laparoscopic cholecystectomy?

A cholecystectomy is an operation to take out your gallbladder. The surgeon will remove it with the help of a tiny camera called a laparoscope. It enables them to see inside your body without having to make large cuts in your abdomen. This is known as ‘keyhole’ surgery.

What happens when I go home?

Most patients go home the same day or the following morning after keyhole gallbladder surgery. Feeling tired for a few days is normal — take things gently while you recover.

Rest and Activity
Rest for the remainder of the day. From the next day, gradually increase activity as you feel able — gentle walking is encouraged, but avoid long walks or strenuous activity for the first few days. Avoid heavy lifting, pushing or strenuous exercise for at least two weeks. Most people return to work within one to two weeks, depending on recovery and job type.

Pain Relief
Tummy, neck or shoulder ache is common for about a week — this is due to the gas used during surgery and settles on its own. You’ll be given pain relief and a stomach-protecting medication to take regularly for 5–7 days. Follow the instructions provided, or check with your pharmacist, doctor or surgical team if unsure.

Eating and Drinking
Eat and drink whenever you’re ready — light meals are best at first.

• Drink plenty of fluids
• Start with small, regular meals
• Gradually return to your usual diet

Temporary bloating or loose stools are common and usually settle with time.

Caring for Your Wounds
Wounds are usually covered with waterproof dressings.

• Dressings – Leave in place for 5 days, then remove or change. Check for redness, swelling or discharge.
• Showering – You may shower after 24 hours. Keep it gentle, avoid rubbing the dressings, and pat dry carefully. For the first week, avoid baths, swimming, soap directly on the wounds, and creams, oils or talc near the site.

Stitches – Usually dissolvable and don’t need removal; may take several weeks (up to two months) to fully dissolve.

Will I need to come back to the hospital?

Before discharge, we’ll explain your follow-up plan. We’ll contact you within a few days, then arrange an in-person appointment a few weeks after surgery.

When to seek medical advice

Contact your surgical team or seek urgent medical attention if you develop:

• Increasing abdominal pain
• Fever or chills
• Redness or discharge from the wounds
• Persistent vomiting
• Yellowing of the skin or eyes (jaundice)
• Shortness of breath or chest pain

Your surgical team will discuss these risks in more detail and answer any questions before your operation