Treatment and surgery options
Once symptoms start, definitive treatment is usually removal of the gallbladder.
Conservative management (selected cases)
- May be reasonable for asymptomatic gallstones
- Pain control and antiemetics during mild episodes
- Dietary fat reduction may reduce symptoms but does not remove stones
Cholecystectomy (gallbladder removal)
Laparoscopic (“keyhole”) surgery
- Small incisions (often 3–4)
- Less pain, faster recovery
- Often same‑day or 1 night hospital stay
Open cholecystectomy
Now uncommon, but sometimes required due to severe inflammation/scarring, bleeding, anatomy, or complications. Recovery is longer due to a larger incision.
Timing: early vs delayed surgery
Why early surgery is often recommended
- Prevents recurrent attacks
- Reduces risk of pancreatitis and cholangitis
- Avoids emergency surgery later (often higher risk)
Why surgery may be delayed in some situations
- Unstable medical status needing optimisation
- Need to treat severe infection first
- Complex bile duct issues needing ERCP/MRCP planning
Risk of “doing nothing”
Even if pain settles, stones remain and can cause recurrent obstruction, infection, pancreatitis, and (rarely) life‑threatening sepsis.
Anaesthesia: what patients should know
- Most laparoscopic cholecystectomies use general anaesthesia
- Common short‑term effects: sore throat, nausea, fatigue
- Serious complications are uncommon but include aspiration, cardiovascular events, allergic reactions
How to reduce anaesthesia risk
Follow fasting instructions, disclose all medications (especially anticoagulants/antiplatelets), and mention sleep apnoea, reflux, prior anaesthetic issues, and allergies.