What are gallstones and when is surgery needed?
Gallstones are hardened deposits that form inside the gallbladder. They range from sand-grain size to several centimetres. Surgery is needed when gallstones cause repeated pain episodes, block bile ducts, or trigger serious complications such as infection or pancreatitis. Deccan Hardikar Hospital in Pune offers laparoscopic cholecystectomy — minimally invasive gallbladder removal — through its General Surgery department at Shivajinagar.
Note: Not every gallstone requires immediate surgery. A specialist assessment determines whether watchful waiting or prompt intervention is appropriate for your case.
What are the symptoms of gallstones?
Many gallstones cause no symptoms and are discovered incidentally during imaging. When symptoms do appear, they typically follow a fatty meal and may include the following:
- Biliary colic — sudden, intense pain in the upper right abdomen or centre of the abdomen, lasting 30 minutes to several hours
- Pain that radiates to the right shoulder or between the shoulder blades
- Nausea and vomiting accompanying the pain episode
- Bloating, indigestion, or a feeling of fullness after meals
- Fever and chills (if infection — cholecystitis — has developed)
- Jaundice — yellowing of the skin or whites of the eyes (if a stone blocks the common bile duct)
- Dark urine and pale or clay-coloured stools (bile duct obstruction)
Symptoms in women may sometimes be mistaken for other conditions. Upper abdominal pain after meals, particularly in women, warrants evaluation for gallstone disease.
Warning: Fever with right-sided abdominal pain and jaundice together may indicate a serious bile duct infection (cholangitis). Seek emergency care immediately.
What causes gallstones to form?
Gallstones form when the chemical balance of bile inside the gallbladder is disrupted. The two main types are cholesterol stones (the most common) and pigment stones.
| Factor | How it contributes |
|---|---|
| Excess cholesterol in bile | Bile cannot dissolve all the cholesterol, which crystallises into stones |
| Excess bilirubin | Liver conditions or blood disorders cause pigment stones to form |
| Incomplete gallbladder emptying | Bile becomes concentrated and promotes stone formation |
| Rapid weight loss | Liver releases extra cholesterol into bile during fat mobilisation |
| Obesity and high-fat diet | Increases cholesterol saturation in bile |
Additional risk factors include female sex, pregnancy, family history of gallstones, diabetes, and prolonged fasting.
What happens if gallstones are left untreated?
Asymptomatic gallstones often remain harmless for years. However, once symptoms begin, the risk of complications rises with each episode. Untreated symptomatic gallstones can lead to:
- Acute cholecystitis — inflammation of the gallbladder, causing severe pain, fever, and requiring urgent treatment
- Choledocholithiasis — a stone migrating into the common bile duct, blocking bile flow
- Cholangitis — bacterial infection of the bile ducts, a potentially life-threatening emergency
- Gallstone pancreatitis — a stone blocking the pancreatic duct, causing acute pancreatitis
- Gallbladder empyema — pus accumulation inside the gallbladder
- Gallbladder perforation — a rare but serious rupture requiring emergency surgery
Stone size alone does not determine risk. Even smaller stones can obstruct ducts and trigger complications. A surgeon's assessment considers stone number, location, and symptom pattern together.
What are the treatment options for gallstones?
Treatment depends on whether gallstones are symptomatic, the patient's overall health, and the presence of complications. The three main approaches are:
- Watchful waiting — appropriate for truly asymptomatic stones discovered incidentally; no intervention unless symptoms develop
- Medication (bile acid therapy) — oral medications such as ursodeoxycholic acid can slowly dissolve small cholesterol stones, but recurrence is common once medication stops; not suitable for all stone types
- Laparoscopic cholecystectomy — surgical removal of the gallbladder through small keyhole incisions; the standard definitive treatment for symptomatic gallstones
Laparoscopic cholecystectomy is performed under general anaesthesia. The surgeon inserts a camera and instruments through three to four small incisions, removes the gallbladder, and closes the incisions. Most patients are discharged within one to two days and return to normal activity within one to two weeks.
For patients with bile duct stones, an endoscopic procedure (ERCP) may be performed before or alongside surgery to clear the duct. Deccan Hardikar Hospital's laparoscopic surgery team in Pune evaluates each case individually to determine the safest approach.
When should you see a doctor or go to the emergency department?
Not every episode of abdominal discomfort requires emergency care, but certain signs demand prompt medical attention. Consult a general surgeon if:
- Upper right abdominal pain lasts more than 4 to 6 hours without relief
- Pain episodes recur more than once in a month
- You notice yellowing of the skin or eyes at any point
- Urine turns dark or stools become pale or clay-coloured
- You have been diagnosed with gallstones and develop a fever above 38°C
Go to the emergency department immediately if you experience:
- Severe, unrelenting abdominal pain with fever and chills
- Rapid heart rate with confusion or low blood pressure (signs of sepsis)
- Sudden worsening of pain after a period of improvement
Tip: If you have had one symptomatic gallstone episode, the likelihood of a second episode within a year is significant. Early surgical consultation avoids emergency presentations.
What foods should you avoid if you have gallstones?
Diet does not dissolve existing gallstones, but it can reduce the frequency and severity of pain episodes and may lower the risk of new stone formation.
Foods to limit or avoid:
- Fried and deep-fried foods (samosas, pakoras, chips)
- Full-fat dairy products — cream, ghee in large quantities, full-fat paneer
- Fatty cuts of meat and processed meats
- Refined carbohydrates — white bread, sugary snacks, pastries
- Very spicy foods that trigger gallbladder contractions
Foods that may help:
- High-fibre foods — whole grains, lentils, vegetables, and fruit
- Lean proteins — fish, skinless chicken, legumes
- Healthy fats in moderation — nuts, seeds, olive oil
- Regular small meals rather than one or two large meals per day
Maintaining a healthy weight through gradual, sustained dietary change is preferable to rapid weight loss, which paradoxically increases gallstone risk.
How does Deccan Hardikar Hospital support patients with gallstone disease?
Deccan Hardikar Hospital in Pune's Shivajinagar is a NABH Pre-Accredited superspeciality hospital with five decades of surgical experience. The General Surgery department manages gallstone disease from initial diagnosis through laparoscopic cholecystectomy and post-operative recovery, with access to emergency and ICU services on the same campus when complications require urgent intervention.
The hospital's patient-centric approach includes transparent cost information before any procedure, so patients and families can make informed decisions without financial uncertainty. Histopathology services are available in-house, supporting complete diagnostic workup for complex cases.
For patients who may also require evaluation of related conditions, the hospital's Urology and General Medicine departments are available within the same facility, reducing the need for referrals elsewhere.
Book a consultation at Deccan Hardikar Hospital
Use the booking form on this page to schedule an appointment with our General Surgery team in Pune, or reach out directly via the contact details above.