Gallstones are hardened deposits that develop inside the gallbladder, ranging from tiny grains of sand to stones as large as a golf ball. They form when substances normally dissolved in bile become concentrated and crystallize over time.

Gallstones: Symptoms, Causes & Painless Treatment in Lahore

Advanced Laparoscopic Gallbladder Surgery by Prof. Dr. Zahid Mahmood

Prof Zahid Mahmood, General and Colorectal Surgeon in Lahore, in scrubs — Prof. Dr. Zahid Mahmood — General, Laparoscopic & Laser Surgeon, Lahore

Welcome

Gallstones are among the most common surgical conditions worldwide. While many people may have gallstones without symptoms, others experience severe pain, infection, jaundice, or pancreatitis that requires prompt medical attention.

At ProfessorZahid.com, our goal is to help you understand gallstones, recognize the warning signs, and make informed decisions about treatment. Whether you are looking for reliable medical information or considering surgery, this guide explains every aspect of gallstones in simple, easy-to-understand language.

With over three decades of surgical experience, Prof. Dr. Zahid Mahmood specializes in modern laparoscopic (keyhole) gallbladder surgery, providing safe, effective, and evidence-based care for patients across Lahore and beyond.

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More than 30 years of surgical experience
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Specialist in minimally invasive surgery
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What Are Gallstones?

Gallstones are hardened deposits that develop inside the gallbladder. They can range in size from tiny grains of sand to stones as large as a golf ball. Some people have a single stone, while others develop multiple stones of different sizes.

Gallstones form when substances normally dissolved in bile become concentrated and crystallize over time. Although many people with gallstones never experience symptoms, others develop painful attacks, inflammation, infection, or serious complications that require surgical treatment.

Diagram of the gallbladder location beneath the liver

What Is the Gallbladder?

The gallbladder is a small pear-shaped organ located beneath the liver on the right side of the upper abdomen. Its main function is to:

Store bile produced by the liver
Concentrate bile between meals
Release bile into the small intestine after eating, especially fatty foods

Bile helps digest fats and absorb fat-soluble vitamins. You can live a completely normal and healthy life without a gallbladder because the liver continues to produce bile even after the gallbladder has been removed.

How Do Gallstones Form?

Gallstones develop when the balance of chemicals in bile is disturbed. This may happen because:

Too much cholesterol is present in bile
Too little bile salt is available
Excess bilirubin accumulates
The gallbladder does not empty completely
Bile remains stagnant for prolonged periods

Over time, microscopic crystals enlarge and eventually become gallstones.

Types of Gallstones

1. Cholesterol Stones

These are the most common type, accounting for approximately 80% of gallstones. Characteristics: yellow or greenish, rich in cholesterol, more common in women, and often associated with obesity and diabetes.

2. Pigment Stones

These stones contain excess bilirubin. They are more common in chronic liver disease, hemolytic anemia, and certain infections.

3. Mixed Stones

Many patients develop stones composed of cholesterol, calcium salts, pigments, and proteins.

Comparison of cholesterol, pigment, and mixed gallstones

How Common Are Gallstones?

Gallstones affect millions of people worldwide. The condition is especially common in adults over 40 years, women, people with obesity, individuals with diabetes, and those with a family history of gallstones. Many people have gallstones without ever knowing it because they remain asymptomatic.

Common Symptoms of Gallstones

The most common symptom is biliary colic, a sudden, intense pain caused by temporary blockage of the cystic duct. Patients may experience:

Pain in the upper right abdomen
Pain in the upper middle abdomen
Pain after eating fatty meals
Pain that radiates to the back
Pain extending to the right shoulder
Nausea
Vomiting
Indigestion
Bloating
Excessive burping
Sweating during painful episodes

Pain may last from 30 minutes to several hours before subsiding.

Warning Signs That Require Immediate Medical Attention

Seek urgent medical care if you experience:

Severe abdominal pain lasting more than six hours
Fever with chills
Yellowing of the eyes or skin (jaundice)
Persistent vomiting
Dark urine
Pale-colored stools
Confusion or severe weakness

These symptoms may indicate serious complications such as acute cholecystitis, bile duct obstruction, cholangitis, or pancreatitis.

Do All Gallstones Need Surgery?

No. Many gallstones are discovered incidentally during an ultrasound performed for another reason. If the stones are completely asymptomatic, immediate surgery may not always be necessary. However, once gallstones begin causing symptoms, recurrent pain or complications become much more likely. In most symptomatic patients, laparoscopic removal of the gallbladder is the recommended definitive treatment because it prevents future attacks and reduces the risk of serious complications.

Treatment: Painless Keyhole (Laparoscopic) Surgery

For gallstones causing symptoms, the safest and most effective treatment is removal of the gallbladder (cholecystectomy). Medicines cannot reliably dissolve stones, and stones almost always return if the gallbladder is left in place — this is because the gallbladder itself, not just the stones inside it, is what keeps forming them.

The good news is that you can live a completely normal, healthy life without your gallbladder. The liver continues to produce bile and simply delivers it straight to the intestine instead of storing it first.

Today, this operation is done by laparoscopic (keyhole) surgery in the vast majority of patients, rather than a large open cut. Through 3–4 tiny openings, the surgeon removes the gallbladder using a small camera and fine instruments. Compared with old-fashioned open surgery, keyhole surgery means:

Much smaller cuts and barely visible scars
Significantly less pain after the operation
A short hospital stay — for most patients, this is a same-day (day-case) procedure
A quicker return to work and normal activity

When the gallbladder is acutely inflamed, surgery performed by an experienced surgeon within 5–7 days of the attack is safe and shortens the total hospital stay. In some cases, it is safer to first settle the inflammation with rest, fluids, pain relief, and antibiotics, and then operate around 6 weeks later once things have calmed down. Your surgeon will advise which approach is right for you.

Overall, laparoscopic gallbladder surgery is very safe. Complications of any kind occur in roughly 10–15% of cases, and the majority of these are minor. A serious complication such as injury to the bile duct is uncommon, occurring in about 1 in 200 operations, and every precaution — including a safe step-by-step surgical technique known as the “critical view of safety” — is taken to keep this risk as low as possible.

Keyhole incision sites for laparoscopic gallbladder surgery compared to open surgery

Recovery After Gallbladder Surgery

The operation is done under general anaesthesia, so you feel nothing during it. Because the cuts are small, discomfort afterwards is usually mild and well controlled with simple painkillers.

Most patients are up and walking the same day
Many go home the same day or the following morning
Light activity and a normal diet can usually resume within a few days
Most people return to light work within about a week, depending on their job and how they feel
Full recovery, including more strenuous activity, is typically complete within 2–4 weeks

Contact your surgeon promptly if, after going home, you develop fever, worsening pain, yellowing of the eyes or skin, or a wound that becomes red, swollen, or leaks fluid — these need to be checked without delay.

Can You Prevent Gallstones? Diet & Lifestyle Tips

Maintain a healthy weight, and lose weight gradually rather than through crash dieting (rapid weight loss can itself trigger gallstones)
Eat a balanced diet rich in fibre, fruit, and vegetables
Cut down on fried, oily, and very high-fat foods
Stay physically active with regular exercise
Avoid skipping meals for long periods, which allows bile to sit stagnant in the gallbladder

When to See a Surgeon in Lahore

If you are getting repeated pain after meals, have been told you have gallstones on ultrasound, or have suffered a gallbladder attack, it is wise to have a surgical consultation before a complication develops. Prof. Dr. Zahid Mahmood is a General, Laparoscopic & Laser Surgeon in Lahore with over three decades of experience in keyhole gallbladder surgery.

👉 Book a consultation today to discuss your symptoms and treatment options, or call 0300-4130159.

Frequently Asked Questions About Gallstones

Can I live a normal life without my gallbladder?

Yes. The gallbladder only stores and concentrates bile — it is not essential for life. After removal, bile flows directly from the liver to the intestine, and the vast majority of people digest food normally and live a full, healthy life.

Is laparoscopic gallbladder surgery painful?

The operation itself is done under general anaesthesia, so you feel nothing during it. Afterwards, because the cuts are tiny, discomfort is usually mild and easily controlled with simple painkillers. Most patients are up and walking the same day.

How soon can I go home and return to work?

Most patients go home the same day or the next morning, and return to light work within about a week, depending on their job and recovery.

Will gallstones come back after surgery?

No. Once the gallbladder is removed, gallstones cannot form in it again. This is why removing the whole gallbladder — rather than just the stones — is the standard, definitive treatment.

Do all gallstones need surgery?

No. Gallstones that cause no symptoms are usually just watched, since most never go on to cause trouble. Surgery is advised once they start causing pain or complications, or in certain special situations (such as very large stones, or gallbladder polyps) that your surgeon will explain.

Medically reviewed by Prof. Dr. Zahid Mahmood (MBBS, FCPS), General, Laparoscopic & Laser Surgeon, Lahore. Source: Bailey & Love’s Short Practice of Surgery, 28th Edition, Chapter 71 — The Gallbladder and Bile Ducts. This article is for general public awareness and education. It is not a substitute for a personal medical consultation. Please see a qualified surgeon for advice about your own condition.