Gallbladder Surgery (Cholecystectomy) in Uberlândia, Brazil

No. Those who have stones and have never had symptoms do not need routine surgery, because the risk of complications is low (0.1% to 0.3% per year). Those who have had biliary colic should be operated on, preferably soon: half of patients have further attacks and the risk of complications rises to 1% to 3% per year. This is the position of the European guideline (EASL 2016).

If there are no symptoms, probably nothing: about 80% of people with stones never feel anything, and only 1% to 4% per year develop symptoms. If there has already been colic, the scenario changes — the chance of new attacks and of complications such as acute cholecystitis, pancreatitis and bile duct obstruction is higher, and these complications are what make surgery more difficult and riskier.

Gallstones do not disappear with teas or diets. Dissolution with medication has a very restricted indication, does not work for most cases and the stones tend to return. Small stones can migrate into the bile duct — and that, instead of solving the problem, causes pancreatitis or jaundice. For symptomatic stones, the reference approach remains removal of the gallbladder.

It is one of the most frequently performed and standardized operations in the world, with very low mortality in the elective setting. The risks exist and are described on this page: bile duct injury (major injury in about 0.2% to 0.4%), bile leak, bleeding and infection, all infrequent. The risk is higher when the gallbladder is severely inflamed — one more reason not to postpone surgery after the first attack.

There is no laser gallbladder surgery. The popular expression refers to laparoscopy, done through small incisions with a camera. Lasers play no role in removing the gallbladder.

For the gallbladder, laparoscopy remains the standard: the most recent meta-analyses show no clinical benefit from robotics, which takes longer and costs more, and a large North American registry found more bile duct injuries with the robot. Dr. Solon performs both techniques and reserves robotics for selected cases — for example, when another operation is performed at the same time. The choice is made together, at the consultation.

Cholecystectomy is performed under general anesthesia, through three or four small incisions (0.5 to 1.2 cm). Surgery usually takes around one hour and may be longer when the gallbladder is severely inflamed or there are adhesions from previous operations.

Discharge usually happens the same day or the next morning. Light activities are resumed in a few days; work without physical effort, in 1 to 2 weeks; physical effort and lifting, generally after 4 weeks. Sick leave is defined individually according to the occupation and each patient's recovery.

Bile is still produced by the liver and reaches the intestine normally — the difference is that there is no longer a reservoir. In the first weeks, smaller meals with less fat are usually better tolerated, and some people notice softer stools, which tend to normalize. There is no mandatory permanent diet: the vast majority return to their usual eating habits.

Yes. A meta-analysis of 76 randomized clinical trials, with more than 100,000 participants, published in JAMA Internal Medicine in 2022, showed that GLP-1 medications increase the risk of gallbladder and biliary diseases (relative risk 1.37), and in weight-loss trials that risk more than doubled (relative risk 2.29), especially with high doses and prolonged use. This does not contraindicate the treatment, which is prescribed and monitored by the attending physician — but anyone losing weight with these medications who feels abdominal pain should be assessed.

Gallstones are a known risk factor for gallbladder cancer, but this cancer is rare and the individual risk of someone with stones is very low — which is why the presence of stones alone is not a reason to operate on someone without symptoms. Changes in the gallbladder wall seen on imaging are what demand attention, and they are assessed case by case. Learn more on the gallbladder cancer page.

Operate right away. The guidelines recommend early surgery in acute cholecystitis — within 72 hours of admission, according to EASL, or within 7 days (and 10 days from the onset of symptoms), according to WSES. A Cochrane review showed that early surgery shortens the total hospital stay by about 4 days, and that 18% of patients who waited needed emergency surgery before the scheduled date. When the initial window has passed, surgery is delayed around 6 weeks, because operating between the 2nd and the 6th week increases morbidity.

I do operate through the SUS. I am a Professor of Surgery at the School of Medicine of the Federal University of Uberlândia and I operate on patients at the university hospital, HC-UFU. The route, however, does not go through my private practice: to be operated on through the SUS you must go to the health post or Basic Health Unit nearest your home, be assessed by a doctor and, if surgery is indicated, be placed in your municipality's regulation queue. The surgeon does not choose who gets operated on through the SUS — the queue is followed strictly, according to SUS rules.