Gallstones — Symptoms and Treatment
Gallstones are mostly cholesterol- or pigment-based deposits that form inside the gallbladder. They are common in the population and many people remain symptom-free for years. The classic symptom is right upper abdominal pain after fatty meals, which may radiate to the back or right shoulder and can be accompanied by nausea and bloating. Most single asymptomatic stones are observed, while recurrent attacks, cholecystitis, bile duct stones or pancreatitis indicate surgery. In Antalya, Dr. Gökhan ATEŞ tailors this decision to each individual patient.
Gallstones are cholesterol or pigment stones that form inside the gallbladder. Small asymptomatic stones are usually observed. Recurrent pain, cholecystitis, common bile duct stones or pancreatitis bring surgery into the discussion. The decision is made by considering symptoms, ultrasound findings, blood tests and the patient's overall health together.
Symptoms
- Right upper abdominal pain after fatty meals
- Pain radiating to the back or right shoulder
- Nausea, vomiting, bloating
- Indigestion, burping, bitter taste in the mouth
- Some patients have no symptoms at all
Why does it occur?
Imbalance between cholesterol, bilirubin and bile salts facilitates stone formation. Female sex, advanced age, pregnancy, rapid weight loss, post-bariatric surgery period, diabetes, family history and certain blood disorders are risk factors.
How is the diagnosis made?
Abdominal ultrasound is the first-line investigation and identifies gallstones with high accuracy. When complications are suspected, liver function tests, bilirubin, amylase and lipase are added, and MRCP or CT is used as needed.
Required tests
- Abdominal ultrasound
- Complete blood count, CRP
- Liver function tests (AST, ALT, ALP, GGT)
- Bilirubin (total/direct)
- Amylase, lipase
- MRCP or CT when indicated
Treatment options
For asymptomatic stones with low complication risk, observation is sufficient in most patients. Recurrent attacks, cholecystitis, bile duct stones or a history of pancreatitis indicate surgery. The standard approach in suitable patients is laparoscopic cholecystectomy.
Comparison table
| Condition | Symptom | Required test | Possible approach | Urgency |
|---|---|---|---|---|
| Gallstones | Pain after fatty meals, bloating | USG, blood tests | Follow-up or surgery | Depends on symptoms |
| Cholecystitis | Prolonged right upper abdominal pain, fever | USG, CRP, WBC | Urgent evaluation / surgery | High |
| CBD stones | Jaundice, dark urine | MRCP, bilirubin | ERCP ± surgery | High |
| Liver cyst | Usually asymptomatic | USG, CT/MRI | Follow-up or surgery | Low–Moderate |
| Hydatid cyst | Right upper abdominal fullness, pain | USG, CT/MRI, serology | Medication ± surgery | Moderate |
When is surgery needed?
- Recurrent biliary colic attacks
- Previous cholecystitis
- Pancreatitis caused by gallstones or migrated bile duct stones
- High-risk polyps
- Suspicious ultrasound findings (e.g. wall thickening)
Is laparoscopic surgery possible?
In suitable patients the standard option is the laparoscopic (keyhole) technique. Small incisions are made and the gallbladder is removed under camera guidance. Severe adhesions or complex anatomy may require conversion to open surgery.
Pre-operative preparation
- Up-to-date blood tests, ECG and additional consultations as needed
- Review of medications (especially blood thinners)
- Anaesthesia assessment
- Fasting instructions before surgery
After surgery
Patients usually mobilise on the same day and can be discharged the following day. In the first weeks, avoiding fatty foods and preferring small, frequent meals is recommended. See the After-surgery nutrition page for details.
Risks and precautions
As with any surgery, bleeding, infection and general anaesthesia-related risks apply. Bile duct injury, bile leak and, rarely, the need for additional intervention are other risks. They are discussed in detail based on the individual patient.
When to go to the emergency department
- Severe abdominal pain lasting longer than 6 hours
- Fever, chills
- Jaundice, dark urine, pale stools
- Persistent vomiting
- Deterioration of general condition
Frequently Asked Questions
Related Pages
Contact & Appointment
Share your existing ultrasound, MRCP, CT/MRI, blood tests or discharge summary to receive preliminary information about the process. A definitive evaluation is only possible after physical examination and the necessary investigations.
The information on this page is provided for general patient education only and does not replace diagnosis, treatment or any surgical decision. An assessment appropriate for you can only be made after a clinical examination and the necessary investigations.