Gallstones.
Gallstones are small stone-like formations within the gallbladder. They are very common and do not always cause symptoms. When symptoms do occur, surgery is often the most effective treatment.
Stones that form when bile chemistry becomes unbalanced.
Gallstones form when an imbalance in liver secretions, including bile salts and other compounds used in fat digestion, causes solid particles to crystallise within the gallbladder. One in five adults has gallstones.
Many people with gallstones have no symptoms and require no treatment. However, for those who do develop symptoms, treatment is strongly recommended. In severe or untreated cases, gallstones can lead to gallbladder infection (cholecystitis), liver infection, or pancreatitis, all of which can be serious. Non-surgical approaches to dissolving gallstones are generally ineffective. Once the gallbladder becomes diseased, it continues to form stones and progressively loses its ability to assist in digestion.
Factors that increase gallstone risk:
- Female sex (particularly during or after pregnancy)
- Excess body weight or rapid weight loss
- Family history of gallstones
- Diet high in fat and refined carbohydrates
- Diabetes and metabolic conditions
- Certain medications including oral contraceptives
- Age over 40
How gallstones present.
Many gallstones are found incidentally during imaging for other reasons. When symptoms do occur, they are often significant.
- Upper right abdominal pain (biliary colic)
- Pain after eating, particularly fatty meals
- Nausea
- Vomiting
- Abdominal bloating
- Jaundice (yellowing of skin or eyes)
- Fever and chills (if infection has developed)
- Dark urine or pale stools
Severe abdominal pain, fever or jaundice associated with known or suspected gallstones requires urgent medical assessment.
Confirming gallstones.
Abdominal ultrasound
The most common and reliable first-line investigation. Ultrasound accurately detects gallstones and can assess the gallbladder wall and bile ducts for complications.
Blood tests
Liver function tests, full blood count and inflammatory markers help assess for infection, bile duct obstruction or pancreatitis.
CT or MRCP
If stones are suspected in the bile duct (choledocholithiasis), or if anatomy needs to be assessed before surgery, CT or magnetic resonance cholangiopancreatography (MRCP) may be used.
Surgical removal is the definitive treatment.
Laparoscopic cholecystectomy
The gallbladder, along with all the stones it contains, is removed using minimally invasive keyhole surgery. It is performed under general anaesthetic and most patients go home the same day or after a single overnight stay. Recovery is typically straightforward.
ERCP (endoscopic stone removal)
If stones have migrated into the bile duct, endoscopic retrograde cholangiopancreatography (ERCP) may be used to clear them before or alongside cholecystectomy.
Gallbladder surgery is performed within the Upper GI & Surgical Care pathway. Before surgery, you complete the Meridian Foundation Program, our structured preparation phase covering health, nutrition, understanding and readiness. A valid referral from your GP or specialist is required. Self-referral is also appropriate.