Do You Need Gallbladder Surgery? What You Need to Know

Many people have gallstones and never know it. Gallbladder surgery, also known as cholecystectomy, is one of the most common surgical procedures performed by general surgeons. However, not everyone with gallbladder issues requires surgery.

So, when is surgery necessary?

And what symptoms indicate that it may be time to have your gallbladder removed?

Dr. Cathryn Coleman, a general surgeon on the medical staff at USMD Hospital at Arlington, explains who needs gallbladder surgery—and why.

What the Gallbladder Does (and Why It Sometimes Fails)

Your gallbladder is a small organ located under the liver that stores and releases bile to help digest fats. Normally, it works quietly in the background of your digestive system. But when it malfunctions—usually due to gallstones—it can become a source of significant pain and even infection.

“Some people unfortunately will form gallstones or what is sometimes called ‘sludge’ in the gallbladder,” Dr. Coleman said. “Sometimes those stones or that sludge will block the little duct that comes off the gallbladder ”

This blockage can lead to inflammation (cholecystitis), pain, jaundice, and in some cases, dangerous complications.

Gallstones Are Common—But Not Always a Problem

Roughly 10–15% of adults in the U.S. have gallstones. But many never experience symptoms.

“Gallstones are very common, and most people won’t ever know they have them,” Dr. Coleman said. “We only recommend surgery if the stones are causing problems.”

Symptoms that may signal a need for surgery include:

• Pain in the upper right abdomen (sometimes radiating to the back or shoulder)
• Nausea or vomiting after meals
• Bloating or gas
• Fever (in more severe cases)
• Jaundice (if a stone blocks the main bile duct)

If patients have one or more of these symptoms, the doctor may order an ultrasound to look for stones, sludge, or signs of inflammation.

Who’s Most at Risk for Gallbladder Problems?

Gallbladder disease can affect anyone, but some people are more likely to develop gallstones than others. Risk factors include:

• Being female
• Age over 40
• Obesity or rapid weight loss
• Family history of gallstones
• A high-fat, low-fiber diet

“We see a lot of gallbladder disease among obese patients and older patients,” Dr. Coleman said. “But I’ve removed gallbladders from 18-year-olds and 80-year-olds. Gallstones can really affect anybody.”

When Surgery Becomes Necessary

If gallstones are causing pain or complications, surgery is typically the best option. Leaving a diseased gallbladder untreated can lead to recurring infections, tissue damage, or even emergency situations.

“We see a lot of ‘angry’ gallbladders coming through the ER,” Dr. Coleman said. “The gallbladder can get so inflamed that the tissue starts to die. And when that happens, the anatomy becomes distorted, and the surgery gets more complex.”

Still, even in emergency cases, open surgery is rarely needed. “I haven’t had to open for a gallbladder in years,” Dr. Coleman said. “We’ve gotten so good at laparoscopy that even complex cases can usually be done minimally invasively.”

What Gallbladder Surgery Involves

The most common procedure to remove the gallbladder is called a laparoscopic cholecystectomy. It’s typically done through four small incisions using a camera and specialized instruments.

“In this procedure, we find the little duct and artery connected to the gallbladder, clip them, and then remove the gallbladder from the liver bed,” Dr. Coleman explains.

In most elective cases, the surgery usually takes under 30 minutes, and patients go home the same day.

Benefits of minimally invasive surgery include:

• Less pain
• Smaller scars
• Faster recovery
• Lower risk of infection

Some surgeons also offer robotic-assisted gallbladder removal, which can provide greater precision. Both laparoscopic and robotic options are safe and effective, and both offer the same advantages for the patient.

What to Expect After Surgery

Most patients recover quickly. “You’ll be sore for about two to three weeks,” Dr. Coleman said. “I tell patients to use their common sense—if something hurts, don’t do it.”

Some people experience temporary digestive changes, such as loose stools or bloating. These usually resolve within a few weeks as the body adjusts to functioning without the gallbladder.

Bottom Line: Surgery Is for Symptomatic Gallstones

Gallbladder surgery is not automatically necessary for every patients’ gallstones. It’s the presence of symptoms—especially recurring pain or signs of inflammation—that usually drives the decision.

“We don’t recommend surgery for everyone with gallstones,” said Dr. Coleman. “But if you’re having pain or complications, surgery can be lifechanging.”

Choosing the Right Surgeon

If you’re considering gallbladder removal, Dr. Coleman recommends looking for a surgeon who specializes in minimally invasive techniques.

“There’s no reason to have open gallbladder surgery anymore,” she said.

With the right care team, gallbladder surgery can offer lasting relief and a quick return to your regular routine—without the pain and unpredictability of a diseased gallbladder.