Professor Thomas J. Hugh
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Conditions · Gallbladder

Gallstones and gallbladder surgery

Gallstones are common, and the operation to treat them is one of the most frequently performed in the country. Here's what they are, when they need treating, and exactly what to expect if you and Tom decide on surgery.

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Keyhole

Small cuts, not open surgery

~1 hr

Typical time in theatre

Day stay

Home the same day for most

1–2 wks

Back to light activity

/ 01What they are

What are gallstones?

Gallstones are hardened deposits that form in the gallbladder, usually from bile cholesterol or pigment. Many people never know they have them. Problems start when a stone blocks bile flow and triggers sudden, gripping upper abdominal pain (biliary colic or a gallbladder attack).

Your gallbladder is a small pouch that sits under your liver and stores bile, the fluid that helps you digest fatty food. Plenty of people have gallstones and never know it, but when a stone blocks the flow of bile, it can cause sudden, gripping pain.

/ 02Symptoms to notice

What gallstones symptoms should you notice?

Typical signs include upper-right or central tummy pain after fatty meals, pain to the back or shoulder blade, nausea, and recurrent indigestion. Jaundice or pale stools need urgent review.
  • Pain in the upper-right or middle of your tummy, often after fatty meals
  • Pain that spreads to your back or right shoulder blade
  • Feeling sick or vomiting during an attack
  • Bloating, indigestion, or burping that keeps coming back
  • Yellowing of the skin or eyes, or pale stools (see someone urgently)
/ 03When surgery helps

Do gallstones always need surgery?

Not always. Silent stones can often be watched. Once pain or inflammation starts, recurring typical pain or complications can lead to a discussion about removing the gallbladder (laparoscopic cholecystectomy).

If your gallstones aren’t causing symptoms, it’s often fine to simply keep an eye on them. Tom will only recommend surgery if it is genuinely appropriate for your situation. The guide to whether gallstones need surgery covers observation, medicines and endoscopy as alternatives.

/ 04The operation

What happens on the day of keyhole gallbladder removal?

Laparoscopic cholecystectomy removes the gallbladder through four small cuts. Most operations take about an hour. Many people go home the same day; some stay one night.
01

Getting you ready

You'll usually come in on the morning of surgery. You'll meet the anaesthetist, and Tom will see you before you go through.

02

The keyhole operation

Through four small cuts, Tom gently frees the gallbladder and removes it. Most operations take around an hour.

03

Waking up

You'll rest in recovery while the anaesthetic wears off. Many people go home the same day; some stay one night.

04

The first week

Tenderness and tiredness are common early in recovery. Pain relief and wound care are tailored to the operation and the individual.

/ 05Recovery & risks

What is recovery like after gallbladder surgery?

Many people eat and walk soon after surgery and return to light activity within one to two weeks. Material risks include bleeding, infection, bile leak, bile-duct injury, retained stones, blood clots, anaesthetic complications and conversion to open surgery. Personal risk and recovery vary.

Consultation covers the expected benefits, alternatives and risks that matter for your health and proposed operation.

/ 06Common questions

Yes, completely. The gallbladder just stores bile. Once it's removed, bile flows straight from your liver into your gut, and most people notice no difference in day-to-day life.

Most people go back to eating normally within a few weeks. A small number find very fatty meals sit less comfortably at first, which usually settles with time.

The keyhole cuts are small, usually under a centimetre, and fade to fine lines over the months that follow.

Most people drive again within a week and return to a desk job in one to two weeks. Heavier work takes a little longer. Tom will give you advice for your situation.

Keyhole gallbladder removal is one of the most common operations, and most are straightforward. In Professor Hugh's study of 2,633 operations, 78% had straightforward findings and there were no major bile duct injuries. About one operation in five was difficult, usually after urgent presentations or jaundice, and those took longer with longer hospital stays. Read the 2,633-patient study.

Most people have no lasting side effects. Some notice looser bowel motions or discomfort after fatty meals in the first weeks, because bile now flows steadily into the gut, and this usually settles as the body adjusts. Persistent diarrhoea, pain or jaundice should be reviewed by your surgeon. Read the recovery guide.

International guidelines recommend early keyhole gallbladder removal for most people with acute cholecystitis who are fit for surgery. These operations are more often complex, and Professor Hugh's unit developed a score using CRP and imaging that predicts a difficult emergency operation so the right surgical team and theatre time are in place. Read the acute cholecystitis study.

/ 07Related reading
/ 08Research

What has Professor Hugh’s research found about gallbladder surgery?

In 2,633 keyhole gallbladder operations by his unit, 78% were straightforward and 22% were difficult, and difficult operations meant longer stays and more bile leaks. A separate study built a three-factor score that predicts a difficult emergency operation from tests done in the emergency department.

Last updated 25 August 2026