Cholecystectomy - Complications of a gallbladder removal

Removal of the gallbladder (cholecystectomy) is a relatively quick and safe procedure, but, like all operations, there is a small risk of complications.

Infection

An infection can occur after any type of abdominal operation and occurs in around 1 in 15 cholecystectomies. Both simple wound infections and infections inside your abdomen can be treated with a short course of antibiotics.

Risks from general anaesthetic

There are several serious complications associated with having a general anaesthetic, but these are very rare. Complications include allergic reaction and death. Being fit and healthy before your operation reduces the risk of any complications occurring.

Bleeding

Bleeding (haemorrhage) can occur after your operation, although this is rare. If bleeding does occur, it may require a further operation through the same keyhole scars as your first operation.

Bile leakage

When the gallbladder is removed, special clips are used to seal the tube that connects the gallbladder to the main bile duct, draining the liver. However, bile fluid can occasionally leak out.

Sometimes this fluid can be drained off. In rare cases, an operation is required to drain the bile and wash out the inside of the abdominal cavity.

Bile leakage occurs in around 1-2% of cases.

Injury to the bile duct

The most serious complication of gallbladder surgery is injury to the bile duct, which occurs in about 1 in 500 cases. If the bile duct is injured during surgery, it may be possible to repair it straight away. In some cases, complex and major corrective surgery is needed after your original operation.

Injury to intestine, bowel and blood vessels

The keyhole instruments used to remove the gallbladder can injure surrounding structures, such as the intestine, bowel and blood vessels. The risk is increased if the gallbladder is inflamed.

This type of injury is rare and can usually be repaired at the time of the operation. Sometimes injuries are noticed afterwards and a further operation is needed.

Deep vein thrombosis

Some people are at a higher risk of blood clots developing during surgery. This is known as deep vein thrombosis and usually occurs in the leg vein.

You may be given compression stockings to wear during the operation to prevent this happening.

Post-cholecystectomy syndrome

Around one in seven people will experience symptoms similar to – though usually much milder – those caused by gallstones after surgery, such as:

abdominal pain
indigestion
diarrhoea
yellowing of the eyes and skin (jaundice)
a high temperature (fever) of 38°C (100.4°F) or above

This is known as post-cholecystectomy syndrome (PCS). PCS remains a poorly understood condition, but it is thought to be caused by altered bile movements through the body. For example, bile may leak up into the stomach, causing irritation.

Some cases of PCS may be the result of stones still trapped in bile ducts.

In most cases symptoms are mild and short-lived, but in around one in three cases symptoms persist for many months. If you do have persistent symptoms, you should contact your GP for advice.

One option is to carry out an endoscopic retrograde cholangiopancreatography (ERCP) to check for any remaining gallstones.

There are also medicines, such as antacids, proton pump inhibitors and loperamide, that can be used to help relieve symptoms such as abdominal pain, indigestion and diarrhoea.