Gallstones and their Treatments

This sections answers the following FAQs regarding gallstones and their available treatment options:

What does my gallbladder do?

What are gallstones? and why did I get them?

Should I have my gallstones treated?

What is a Laparoscopic Cholecystectomy?

Do I have to have my gallbladder removed?

Can the gallstones be removed without the gallbladder?

Can I live without my gallbladder?

Can the gallstones be dissolved?

Further reading

What does my gallbladder do?

The gallbladder is found lying near to the liver. The liver produces a green fluid known as bile, which breaks down the fat we take in our diet. The bile produced is stored in the gallbladder. When we eat a meal that contains a lot of fat the gallbladder releases some of the bile to digest the fats.

What are gallstones? and why did I get them?

Gallstones are solid ‘stones’ that form in the gallbladder. In some patients, the bile becomes rather thick and some of its constituents form gravel-like deposits that later clump together to form stone (gallstones).

Women are nine times more likely to have gallstones than men, and that reflects the hormonal changes that women get with periods, pills and pregnancies. These hormonal changes alter the composition of the bile and disturbs the balance between its various chemicals, some of which then form sand which later turns into stones. Also losing weight quickly or putting it back on quickly can lead to gallstones forming. In some patients there may be an obscure genetic factor, as gallstones run in some families.

Should I have my gallstones treated?

In the majority of patients (usually women), gallstones cause no symptoms or problems whatsoever, and are only accidentally found on an ultrasound scan of the abdomen or an X-ray that was carried out for another reason. If so, these gallstones do not need any treatment and can be ignored, except perhaps in young patients who are likely to run into truble from their gallstones over a course of 20-40 years.

If the gallstones however cause symptoms such as pain, or complications such as inflammation of the gallbladder (cholecystitis) or pancreas (pancreatitis), or obstruction of the bile duct with yellow discolouration of the skin (jaundice) then removal of the gallbladder by an operation (usually a keyhole operation, called laparoscopic cholecystectomy) becomes necessary otherwise the gallstones almost always cause more problems, some of which are potentially serious.

What is a Laparoscopic Cholecystectomy?

This is removal of the gallbladder by an operative technique that is called laparoscopic surgery, better known as keyhole surgery.

The term cholecystectomy simply means removal of the gallbladder. Although we have traditionally removed the gallbladder by an ‘open’ operation through a fairly big cut in the tummy in the past, we can now remove the gallbladder by a keyhole technique (laparoscopic). This involves making a few (usually 4-5) small incisions (between ½-1 cm) in your abdomen to remove the gallbladder.

Do I have to have my gallbladder removed?

We know that once the gallstones have caused symptoms, they go on to cause more symptoms or complications in the future. Whilst adhering to a low-fat diet might reduce the frequency of your pain, it does not prevent further attacks of pain and does not guarantee fredom from complications. If you are fit for surgery, there is no doubt that this is the best course of action.

Can the gallstones be removed without the gallbladder?

Although this is technically feasible, leaving the gallbladder (the factory of gallstones) behind can only risk the development of more stones. There is little value in such approach and it is not normally practiced.

Can I live without my gallbladder?

We can live without the gallbladder with no ill effects. The body adapts to the removed gallbladder quite well, and the bile duct gradually dilates to store more bile and take on the function of the removed gallbladder.

Can the gallstones be dissolved?

Whilst there are medications available to dissolve gallstones, their use is quite unpopular for several reasons:

The gallbladder has to be functioning
The stones ought to be of a certain type (cholesterol stones)
The stones ought to be small in size (less than 15 mm)
The medications ought to be taken for 2 years

As a result, only a small proportion of patients are suitable for this therapy and many patients drop out of treatment due to side effects. This treatment is therefore only successful in less than a third of patients, and in most the stones recur after discontinuation of treatment. We would only recommend this therapy in patients unfit for surgery.

For further reading on this subject click on the following links:

Further reading:

For further reading on gallstones and their treatments you may also click on the following links:

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