Gallstones are small, stone-like formations that have solidified from bile. Around one in six Germans has gallstones, around 2/3 of whom are women.
However, only around a quarter of those affected actually suffer from symptoms.
Gallstones can narrow the bile ducts and thus lead to various symptoms. In the case of bile stasis, for example, the bile can no longer flow out. This manifests itself, for example, in
Gallstones can also cause biliary colic. This is manifested by nausea and vomiting as well as an increase in blood pressure.

Illustration of gallstones in the gallbladder © Henrie | Fotolia
As long as the patient has no symptoms, gallbladder surgery is not necessary. Only when the patient suffers from symptoms should an operation be considered.
Complete removal of the gallbladder is not always necessary. It may be possible to remove the gallstones and preserve the gallbladder.
The doctor will decide which form of surgery is most suitable. This depends on
- the location and size of the gallstones and
- the general condition of the person suffering
suffering from it.
Endoscopic gallstone removal
Endoscopic gallstone removal is performed using the ERCP method (endoscopic retrograde cholangiopancreatography).
The doctor inserts an endoscope directly into the bile duct via the oesophagus, stomach and small intestine. Smaller gallstones blocking the bile duct can now be removed via the endoscope using small forceps.
Gallstone removal using shock wave therapy
In the past, the stones were also treated with medication (litholysis) and shock wave therapy using ultrasound. This procedure is called extracorporeal shock wave lithotripsy(ESWL).
Quite small stone fragments are produced during fragmentation. They are flushed out by themselves via the bile duct. Alternatively, they can be completely dissolved with the help of oral medication.
However, ESWL does not eliminate the cause of the formation of gallstones. Gallstones can recur after they have been broken up. For this reason, stone fragmentation and litholysis are generally no longer used today.
Removal of the gallbladder
Nowadays, cholecystectomy (surgical removal of the gallbladder) is no longer a major procedure. It is usually performed using a minimally invasive procedure known as the keyhole method.
The surgeon makes several small incisions of around 3 millimeters in the abdominal wall. Through these incisions, he inserts the instruments required for the operation, such as
- camera,
- light source and
- surgical tool
into the abdominal cavity. This type of operation is also known as laparoscopy. The image from the camera is transmitted to a monitor in real time. This allows the surgical team to see all structures clearly under magnification. The surgeon removes the gallbladder together with the gallstones without having to open the skin with a large incision.
The small incisions for the surgical instruments usually heal quite quickly and with little pain. They leave very small scars at most.