Gallstones are one of the most common surgical conditions in Pakistan — and if you have been experiencing pain in your upper right abdomen, especially after fatty meals, you may already know why. The good news is that the solution is straightforward: laparoscopic cholecystectomy — keyhole removal of the gallbladder — is one of the safest, most commonly performed operations in the world, with a short hospital stay, minimal pain, and a fast return to normal life.
What is the gallbladder and what does it do?
The gallbladder is a small, pear-shaped organ tucked under the liver on the upper right side of the abdomen. Its job is to store bile — a digestive fluid produced by the liver — and release it into the small intestine after meals to help break down fats.
When the gallbladder is removed, the liver continues to produce bile, which now flows directly and continuously into the small intestine. Most people adjust to this change within a few weeks and experience no lasting digestive problems. A life without a gallbladder is entirely normal and healthy.
What are gallstones and why do they form?
Gallstones are hard deposits — ranging from the size of a grain of sand to a golf ball — that form inside the gallbladder when the chemical balance of bile becomes disrupted. The most common type are cholesterol gallstones, which form when bile contains too much cholesterol relative to bile salts and water.
Who is more likely to develop gallstones?
- Female sex — gallstones are four times more common in women than men, particularly during and after pregnancy
- Obesity — excess body weight increases cholesterol secretion into bile
- Rapid weight loss — including after bariatric surgery
- Family history of gallstones
- Age over 40
- Diet high in fat and low in fibre
- Diabetes — associated with increased cholesterol in bile
Symptoms of gallstones — when to see a surgeon
Many gallstones cause no symptoms at all and are discovered incidentally on an ultrasound. However, when gallstones cause symptoms, surgery is almost always the definitive answer. Once symptoms begin, they tend to recur and worsen over time.
- Biliary colic: sudden, intense pain in upper right abdomen, lasting 30 minutes to several hours, typically triggered by fatty meals
- Pain radiating to right shoulder or between shoulder blades: classic pattern of gallbladder pain
- Nausea and vomiting during pain episodes
- Pain after fatty meals — fried food, biryani, curries with ghee
- Fever, chills, persistent pain (cholecystitis): gallbladder infection — requires prompt assessment
- Jaundice (yellowing of skin or eyes): stone has entered the bile duct — urgent assessment needed
- Pale stools and dark urine with jaundice: bile duct obstruction — requires urgent treatment
When is surgery urgent?
- Fever above 38.5°C with upper right abdominal pain — possible cholecystitis or cholangitis
- Jaundice with pain — possible common bile duct stone
- Severe, constant pain that does not settle — possible gallbladder perforation
These symptoms require same-day surgical assessment — do not wait for a routine appointment.
Why surgery is the only permanent solution
Once gallstones form and cause symptoms, non-surgical treatments — including medications, dietary changes, and ultrasound-based stone breaking — do not provide a reliable or lasting solution. The only accepted, evidence-backed permanent treatment for symptomatic gallstones is removal of the gallbladder. Since the gallbladder itself has a fault in its bile concentration and emptying, removing stones while leaving the gallbladder in place simply results in new stones forming.
Laparoscopic cholecystectomy is the gold-standard treatment worldwide and has been for over 30 years. It is the most commonly performed elective surgical procedure globally.
What is laparoscopic cholecystectomy?
Laparoscopic cholecystectomy is the keyhole surgical removal of the gallbladder. Instead of a large open incision, the procedure is performed through three to four tiny cuts of approximately 1 cm each in the abdomen. A laparoscope — a thin tube fitted with a high-definition camera and light — is inserted through one incision, projecting a magnified live view onto a monitor.
Laparoscopic vs open cholecystectomy
- Incision: 3–4 cuts of 1 cm vs 1 cut of 10–15 cm
- Hospital stay: Same day or 1 night vs 3–5 nights
- Return to work: 5–7 days vs 4–6 weeks
- Pain after surgery: Mild — oral pain relief usually sufficient vs significant
- Scarring: Minimal, barely visible vs large permanent scar
- Conversion to open: Required in approximately 3–5% of laparoscopic cases
What to expect — step by step
Step 1 — Consultation and diagnosis
The essential investigation is an abdominal ultrasound, which confirms the presence, size, and number of gallstones and assesses the gallbladder wall thickness and bile duct width. Blood tests are also taken to check liver function, check for infection or obstruction, and assess surgical fitness.
Step 2 — Pre-operative assessment (1–2 weeks before surgery)
- Full blood panel — complete blood count, liver function tests, kidney function, coagulation screen
- Abdominal ultrasound (if not already done)
- ECG for patients over 40 or with cardiac history
- Anaesthesia assessment and pre-operative instructions
- Fasting from midnight before surgery
Step 3 — The operation (30–60 minutes)
Performed under general anaesthesia. Three to four incisions of approximately 1 cm each are made. Carbon dioxide gas is gently introduced to inflate the abdominal cavity. The cystic duct and cystic artery are carefully identified, clipped, and divided. The gallbladder is then separated from the liver and removed through one of the small incisions. A cholangiogram (X-ray of the bile ducts using contrast dye) may be performed if there is any suspicion of stones in the common bile duct.
Step 4 — Recovery in hospital
Most patients are able to go home on the same day, or after one night in hospital. Pain is well controlled — most patients require only oral paracetamol or ibuprofen. Oral fluids are introduced within a few hours of surgery, and most patients are walking within 2 to 3 hours of waking from anaesthesia.
Step 5 — Recovery at home
- Days 1–2: Rest at home. Mild soreness around incision sites. Shoulder tip pain possible (from carbon dioxide gas — resolves within 24–48 hours).
- Days 3–5: Energy improves noticeably. Light activities. Short walks encouraged.
- Days 5–7: Most desk-based and office workers return to work. Driving can usually resume.
- Weeks 2–3: Light exercise resumes. Physical work can gradually increase.
- Week 6: Full physical activity including heavy lifting and strenuous exercise for most patients.
Diet after gallbladder removal
The majority of people return to a completely normal diet within a few weeks. In the first 2 to 4 weeks after surgery, a few temporary adjustments help your digestive system adapt:
- Eat small, frequent meals rather than large portions
- Reduce fatty, fried, and very rich foods temporarily
- Increase fibre gradually — vegetables, fruits, and whole grains
- Stay well hydrated — at least 6 to 8 glasses of water daily
- Avoid very spicy food initially if it causes discomfort
A small proportion — around 5 to 10 percent — experience loose stools or mild diarrhoea after fatty meals for several weeks. This usually resolves on its own as the body adjusts.
Risks and complications
The overall complication rate in Pakistani patients in published studies is approximately 6.8% — the majority being minor and manageable. Serious complications are rare.
Common minor side effects
- Shoulder tip pain — caused by residual carbon dioxide gas; resolves within 24 to 48 hours
- Mild nausea after general anaesthesia
- Bruising and mild soreness at incision sites
- Temporary loose stools or changed bowel habit
Rare but serious complications
- Bile duct injury: the most serious potential complication, occurring in approximately 0.3 to 0.5% of cases
- Bile leak: usually managed with a drainage procedure
- Bleeding: rare; usually controllable laparoscopically
- Wound infection: uncommon; treated with antibiotics
- Retained common bile duct stone: treated with endoscopy (ERCP)
- Conversion to open surgery: required in approximately 3 to 5% of laparoscopic cases — a safety decision, not a complication
Cost of gallbladder surgery in Lahore
- Slim Expert — standard: PKR 1,75,000 – 2,50,000 (surgeon fee, anaesthesia, theatre, 1–2 nights hospital, post-op follow-up)
- Slim Expert — day case: PKR 1,50,000 – 2,00,000 (same-day discharge where appropriate)
- UK / NHS equivalent: PKR 8,00,000 – 15,00,000
- UAE / Saudi Arabia: PKR 5,00,000 – 10,00,000
Why choose Prof. Maaz Ul Hassan for gallbladder surgery?
- 12,000+ laparoscopic and bariatric procedures — highest volume in Pakistan
- 28+ years of exclusive specialization in laparoscopic and minimally invasive surgery
- International training: FCPS (Pakistan), FLS (USA), Diploma in Laparoscopic Surgery (France)
- Professor of Surgery at Shalamar Institute of Health Sciences
- Pioneer of laparoscopic surgical education in Pakistan
- Patients travel from Karachi, Islamabad, Faisalabad, Peshawar, and internationally
Frequently Asked Questions
Do I really need surgery, or can I manage with diet?
Diet changes can reduce the frequency and severity of gallstone attacks, but they cannot remove existing gallstones or cure the underlying problem. Once gallstones cause symptoms, surgery is the only permanent solution.
How long will I be in hospital?
Most patients are discharged on the same day or after one night. Patients with cholecystitis or additional medical conditions may require 2 to 3 nights.
Will I be in a lot of pain?
Most patients find laparoscopic cholecystectomy far less painful than they expected. The most common discomfort is shoulder tip pain in the first 24 to 48 hours, which resolves on its own. The vast majority of patients do not require strong opioid pain medication after going home.
How soon can I return to work?
Most patients in desk-based jobs return within 5 to 7 days. Those in physically demanding roles typically require 2 to 3 weeks.
Can I eat normally after gallbladder removal?
Yes — the vast majority of patients return to a completely normal diet within 4 to 6 weeks of surgery.
Is it safe to delay gallbladder surgery?
If your gallstones are asymptomatic, watchful waiting is appropriate. Once symptoms begin, delaying carries real risks — cholecystitis, choledocholithiasis (stones in the common bile duct), gallstone pancreatitis, and in rare cases, gallbladder perforation. Emergency surgery for complicated gallstone disease carries a significantly higher risk than planned elective surgery.
Gallstones causing you pain? Book your consultation
If you have been experiencing upper abdominal pain after meals — or have already been told you have gallstones on ultrasound — book a consultation with Prof. Maaz Ul Hassan at Slim Expert in Lahore.
Call / WhatsApp: 0305-9738995
Location: Lahore, Punjab, Pakistan. Video consultations available for patients outside Lahore.
Gallstones do not resolve on their own. The sooner you act, the simpler and safer the solution.
Book a consultation: Patient portal · +92 329 166 4350