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At a glance
- Cholecystectomy is surgery to remove the gallbladder, usually because of gallstones causing symptoms.
- It is most often done by keyhole (laparoscopic) surgery as a day or short-stay procedure.
- You can live normally without a gallbladder — the liver still makes bile.
- It is one of the most common abdominal operations.
What it is
Cholecystectomy is an operation to remove the gallbladder, a small pear-shaped pouch that sits under the liver on the right side of the upper abdomen. Its job is to store and concentrate bile, a fluid the liver makes to help digest fat. The gallbladder squeezes bile into the intestine after meals, but it is not an essential organ, and the digestive system continues to work well without it. The great majority of these operations are done because gallstones — hardened deposits that form inside the gallbladder — have started to cause pain or complications. Most gallbladders today are removed by keyhole (laparoscopic) surgery, and a smaller number by open surgery when keyhole is not suitable. In Singapore the procedure is carried out by a general or hepatobiliary surgeon, typically in a hospital such as SGH or NUH after a referral and assessment.
Why it is done
Removal is recommended when gallstones cause problems: repeated gallbladder pain (biliary colic), inflammation of the gallbladder (cholecystitis), a stone that has slipped out and blocked the bile duct, or gallstone-related pancreatitis (inflammation of the pancreas). These episodes can bring severe pain in the upper abdomen, sometimes spreading to the back or right shoulder, and may come with nausea, vomiting, fever or yellowing of the skin. Once gallstones have caused a serious attack, further attacks are likely, so surgery is usually advised to prevent them. Occasionally the gallbladder is removed for other reasons, such as certain gallbladder polyps or, rarely, a suspected gallbladder tumour. Gallstones that produce no symptoms at all usually do not need surgery.
Alternatives
If gallstones are found by chance and are not causing symptoms, the usual approach is watchful waiting — simply monitoring, with surgery reserved for if problems develop. Managing the underlying cause matters too: keeping to a healthy weight, a balanced lower-fat diet and treating related conditions such as fatty liver disease can support gallbladder health. Painkillers and dietary changes may ease occasional mild symptoms for a time, but they do not dissolve stones or stop attacks returning. For most people with symptomatic gallstones, removing the gallbladder remains the definitive treatment, because stones tend to keep forming as long as the gallbladder is in place. Your surgeon can explain which path fits your situation.
How it is done
Most gallbladders are removed by laparoscopic (keyhole) surgery under general anaesthesia. The surgeon makes a few small cuts in the abdomen, gently inflates the space with gas to create room to work, and passes a slim camera and fine instruments through the openings. Watching the view on a screen, the surgeon separates the gallbladder from the liver and bile duct, seals the vessels and the tube (cystic duct) that connect it, and removes the whole gallbladder through one of the small cuts. Sometimes an X-ray of the bile ducts is taken during the operation to check for stones. Occasionally the operation is converted to open surgery, done through a single larger cut, when the anatomy is unclear or there is severe inflammation, scarring or bleeding; this is a sound safety decision rather than a complication. The small wounds are closed with stitches or surgical glue and covered with dressings.
Preparation
Before surgery you will usually have blood tests and scans such as an ultrasound to map the gallstones and ducts. Tell the surgical team about all your medicines, including blood thinners, supplements and traditional remedies, as some may need to be paused, and mention any allergies or previous problems with anaesthesia. You will normally be asked to fast — nothing to eat or drink — for several hours beforehand, and you will be told exactly when to stop. It helps to stop smoking, arrange time off work, and organise someone to take you home and stay with you for the first night, since you should not drive immediately after a general anaesthetic. The anaesthetist and surgeon will explain the plan and answer questions before you sign the consent form.
Recovery
Recovery from keyhole surgery is usually quick. Many people go home the same day or after a short overnight stay. It is normal to feel some soreness around the small wounds and, for a day or two, an aching discomfort in the shoulder tip from the gas used during surgery, which passes on its own. Most people return to light activities and gentle walking within a few days and to normal routines, including work and driving, over about one to two weeks, avoiding heavy lifting and strenuous exercise at first. Simple pain relief, keeping the wounds clean and dry, and moving about gently all help. Open surgery involves a larger wound and a longer recovery, often with a hospital stay of several days and more weeks before full activity. Your team will give tailored advice on wound care, showering, stitches and when to resume driving and work.
Life without a gallbladder
The gallbladder stores and concentrates bile, but it is not essential — after removal, bile simply flows directly and continuously from the liver into the intestine. Most people eat normally and notice no lasting difference. Some find that in the early weeks they have looser or more frequent stools, or that very rich, oily or large meals are harder to tolerate; this usually settles as the body adjusts. Building fatty foods back gradually, eating smaller and more regular meals, and keeping to a balanced diet can smooth the transition. A small number of people have longer-lasting changes in bowel habit and should mention this to their doctor, as it can be managed. There is no special long-term diet that everyone must follow.
Risks and complications
Cholecystectomy is generally safe, but as with any operation there are risks. These include bleeding, wound or internal infection, and a reaction to the general anaesthetic. Specific to this surgery are injury to the bile duct or to nearby structures such as the bowel or blood vessels, a bile leak from the ducts, and stones that were already sitting in the bile duct being left behind (retained stones), which may need a further procedure to remove. There may also be a collection of fluid or a small hernia at a wound site. Serious complications are uncommon, and your surgeon will explain how each is watched for and managed. Knowing the warning signs helps you get prompt help if something is not right.
When to seek help after
After going home, seek urgent medical care if you develop worsening or severe tummy pain, a fever or chills, yellowing of the eyes or skin (jaundice), persistent vomiting or inability to keep fluids down, or a wound that becomes increasingly red, swollen, painful or is discharging fluid. Very heavy bleeding, breathlessness, chest pain or a swollen, painful calf also need emergency attention. In Singapore you can attend a hospital emergency department, or call 995 for an ambulance if symptoms are severe or you feel very unwell. These signs can point to infection, a bile leak, a blocked duct or a retained stone, all of which are treatable, especially when caught early.
When to see a doctor
See a doctor for recurrent gallbladder pain or complications of gallstones to discuss whether removal is appropriate. After surgery, seek review for fever, worsening pain, jaundice (yellowing), or persistent vomiting.
Common questions
Can I live without a gallbladder?
Yes. Bile flows directly from the liver to the intestine, and most people eat and live normally afterwards.
Is gallbladder removal major surgery?
It is usually keyhole surgery with a quick recovery, though it is still an operation under general anaesthesia.
Will I need a special diet afterwards?
Most people return to a normal diet; a lower-fat diet in the early weeks can help while the body adjusts.
Related guides
Sources
- HealthHub Singapore — gallstones and gallbladder surgery.
- Ministry of Health Singapore — cholecystectomy.
- NHS — gallbladder removal.
This article is for general information only and does not replace a consultation with a qualified doctor. Please seek personalised medical advice for your situation.