Gallstones are found incredibly often on ultrasound scans — frequently when the scan was done for something else entirely. Understandably, the first question is: do these need to come out?
For most people, the answer is no. This surprises patients, so it's worth explaining properly.
The majority of people with gallstones never develop any symptoms from them. These are described as asymptomatic or "silent" gallstones, and the widely accepted position internationally is that silent gallstones generally do not require surgery. The risk of a silent stone going on to cause a serious problem is low, and operating on everyone with stones would mean a great many unnecessary operations.
If your stones were an incidental finding and you have never had symptoms, watchful waiting is usually appropriate — alongside sensible measures such as maintaining a healthy weight and a balanced, not excessively fatty, diet.
Once gallstones start causing symptoms or complications, the picture changes and surgery is usually recommended. The common reasons are:
There are also selected situations — such as certain gallbladder polyps, a calcified "porcelain" gallbladder, or particular risk factors — where removal may be advised even without classic symptoms. This is an individual assessment.
This is a fair question. The reason is straightforward: if the gallbladder is left in place, stones reliably form again. The problem is not really the stones themselves but the gallbladder's tendency to produce them. Removing the stones alone would simply delay the same problem.
You can live an entirely normal life without a gallbladder. The liver continues to produce bile, which simply flows directly into the intestine rather than being stored and released in bursts.
Most people notice no lasting change in digestion. A minority find that very fatty or fried meals are best reintroduced gradually in the first few weeks, and some experience temporarily looser stools that settle over time.
Laparoscopic cholecystectomy is among the most common and well-established operations performed worldwide. The gallbladder is removed through three or four keyhole incisions, usually as a day-care procedure or with a single overnight stay. Most patients return to desk work within about a week.
The free Gallstones & Gallbladder Surgery handbook covers the operation, recovery and diet in detail.
A scan showing gallstones is not, by itself, a reason to have surgery. If the stones are silent, monitoring is usually the right approach. If they are causing pain, inflammation, jaundice or pancreatitis, removal is generally recommended — and the keyhole operation is safe, quick and well tolerated.
Bring your scan and reports to a consultation and you'll get a straight answer about which group you're in.
This article is for general patient education only and does not constitute medical advice, diagnosis or treatment. Individual circumstances, risks and recovery vary — please consult a qualified medical professional for advice specific to your condition.