Gallbladder Surgery (Laparoscopic Cholecystectomy) in New Zealand
Gallbladder surgery, most commonly performed as a laparoscopic cholecystectomy, is the definitive treatment for symptomatic gallstones and most gallbladder disorders.
Dr Peter Carr-Boyd is a specialist general surgeon with broad gastrointestinal and hepatobiliary training. He uses minimally invasive procedures to reduce risk and recovery time for his patients.
How Laparoscopic Cholecystectomy Is Performed
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Laparoscopic cholecystectomy is performed under general anaesthesia and removal of the gallbladder from the liver bed is done through 4 small abdominal incisions.
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Most patients go home the same day or the following morning.
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You can expect return to light activity within days and full recovery in 2–3 weeks.
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There are a few risks associated with the operation that will be discussed with you beforehand so that you are fully informed.
When Should You See a Specialist?
We recommend you book an assessment if you experience:
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Recurrent right upper abdominal or epigastric pain
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Pain triggered by fatty meals
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Gallstones detected on ultrasound with symptoms
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Fever, jaundice, or persistent pain
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A history of gallstone pancreatitis or bile duct stones
Early assessment allows timely treatment and reduces the risk of complications.
1. Gallstones and Gallstone related complications
Cholecystectomy, or gallbladder removal surgery, is recommended for patients with gallstones or gallstone-related complications when symptoms are present or when there is a risk of serious complications. Dr Carr-Boyd ensures surgery is guided by evidence-based practice and tailored to each patient’s clinical situation.
Symptomatic Gallstones
Gallbladder surgery is recommended for patients with symptomatic gallstones, typically presenting as biliary colic or gallstone-related complications.
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Symptoms include recurrent upper abdominal pain, particularly after fatty meals, nausea, or vomiting
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The risk of recurrent pain and complications increases over time
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Laparoscopic (keyhole) cholecystectomy is the recommended treatment
Asymptomatic gallstones do not usually require surgery, including in patients with cirrhosis, unless additional high-risk features are present (such as suspicious gallbladder polyps).
Acute Cholecystitis
For most patients with acute cholecystitis, early laparoscopic cholecystectomy is recommended, ideally within 1–3 days of diagnosis.
Early surgery is associated with:
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Lower complication rates
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Shorter hospital stay
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Faster recovery and reduced healthcare costs
In patients with very high surgical risk (for example, severe medical comorbidities or advanced cirrhosis), alternatives such as percutaneous cholecystostomy or gallbladder drainage may be considered.
Bile Duct Stones and Ascending Cholangitis
Patients with ascending cholangitis are initially treated with endoscopic stone removal (ERCP). After ERCP, cholecystectomy is recommended to prevent recurrence of:
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Bile duct stones
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Cholangitis
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Gallstone pancreatitis
Managing Bile Duct Stones During Gallbladder Surgery
In some patients with gallstones and bile duct stones (choledocholithiasis) who do not have cholangitis or active infection, bile duct stones can be treated at the time of gallbladder surgery.
During laparoscopic cholecystectomy, laparoscopic bile duct exploration may be performed to remove stones from the common bile duct. This approach can safely clear bile duct stones and, in appropriate cases, avoid the need for a separate endoscopic procedure (ERCP).
Benefits of Single-Stage Surgery
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Treatment of gallbladder and bile duct stones in one operation
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Reduced need for multiple procedures
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Shorter overall treatment time
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Faster recovery
The decision to perform bile duct exploration depends on stone size and number and anatomy of the bile ducts. Dr Carr-Boyd carefully assesses these factors to ensure the procedure is appropriate and performed safely.
Gallstone Pancreatitis
In patients with mild gallstone pancreatitis, same-admission cholecystectomy is recommended to reduce the risk of recurrent pancreatitis and hospital readmission. If
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Delaying surgery increases the risk of recurrent biliary events
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In moderate or severe pancreatitis, surgery is usually delayed until recovery and resolution of inflammation, typically 6–8 weeks after the acute episode.
2. Gallstones and Gallbladder Disease in Pregnancy
Gallbladder disease is relatively common during pregnancy and may cause significant pain or complications if not managed appropriately.
Why Gallstones Are More Common in Pregnancy
Hormonal changes in pregnancy play a key role in gallstone formation. Elevated oestrogen and progesterone levels:
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Increase cholesterol saturation in bile
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Reduce gallbladder contractility
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Promote bile stasis
These changes increase the likelihood of gallstone and biliary sludge formation. Gallstones or biliary sludge occur in approximately 8–10% of pregnancies, with symptomatic disease affecting around 0.5–0.8% of pregnant patients.
Diagnosis of Gallstones in Pregnancy
Ultrasound is the first-line investigation for suspected gallbladder disease in pregnancy. It is safe, widely available, and highly sensitive for gallstones and biliary sludge.
If complications such as bile duct stones are suspected:
MRCP and endoscopic ultrasound (EUS) are preferred, as they avoid ionising radiation.
other causes of Right Upper Abdominal Pain in Pregnancy
Right upper quadrant pain in pregnancy can have other causes, including:
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Acute appendicitis
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HELLP syndrome
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Pre-eclampsia
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Acute fatty liver of pregnancy
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Other hepatobiliary or gastrointestinal conditions
Often collaboration with an Hepatologist and your Obstetrician is essential, and Dr Carr-Boyd will ensure a careful assessment is made to ensure timely and accurate diagnosis.
Management of Gallstones in Pregnancy
Management depends on symptom severity and gestational age.
For uncomplicated biliary colic, supportive management may be trialled initially. However, recurrence rates are high, particularly when symptoms occur early in pregnancy, thus early laparoscopic cholecystectomy is recommended. The second trimester is often preferred due to lower risks of miscarriage and preterm labour but surgery should not be delayed if clinically indicated and especially for complicated gallstone disease.
3. Gallbladder polyps and masses
What Are Gallbladder Polyps?
Gallbladder polyps are growths that arise from the inner lining of the gallbladder. They are commonly detected incidentally during an ultrasound scan performed for abdominal pain or gallstones.
Most gallbladder polyps are benign (non-cancerous) pseudo-polyps that are inflammatory or composed of cholesterol, particularly when they are small. However, a small proportion can represent pre-cancerous or cancerous changes, which is why careful assessment is important.
When Is Cholecystectomy Recommended for Gallbladder Polyps?
Removal of the gallbladder (cholecystectomy) is generally recommended for gallbladder polyps ≥1cm in diameter. This threshold is based on the increased risk of cancer in larger polyps; although the overall risk of gallbladder polyps being cancer is still very low even in polyps greater than 1cm. For patients with primary sclerosing cholangitis (PSC), the threshold is lower; cholecystectomy is recommended for polyps ≥8 mm due to the higher risk of gallbladder cancer in this population.
Additional risk factors that may indicate the need for surgical removal include: Age >50–60 years; unusual shape of the polyp; single polyp; rapid growth (>2 mm increase in size); gallbladder wall thickening especially if localised to the fundus (end) of the gallbladder; coexistent gallstones; and Asian ethnicity.
For polyps 6–9 mm, surveillance with serial ultrasound is appropriate in the absence of risk factors, with cholecystectomy considered if growth, new risk factors, or symptoms develop.
When Are Further Investigations Needed?
Most gallbladder disease is detected on an ultrasound. However, Dr Carr-Boyd may recommend additional imaging such as a Liver MRI when ultrasound findings are unclear or concerning for gallbladder cancer.
MRI provides more detailed information than ultrasound and helps guide surgical planning.
When Is More Extensive Surgery Required?
If imaging if concerning for early gallbladder cancer, standard gallbladder removal alone may not be sufficient.
In these cases, surgery may involve:
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Removal of the gallbladder
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Resection of a small portion of adjacent liver tissue
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Removal of surrounding lymph nodes
Dr Carr-Boyd is trained to undertake this more extensive surgery which improves the chance of complete cancer removal when disease is detected at an early stage.
4. Diet After Gallbladder Removal
How Gallbladder Removal Affects Digestion
After gallbladder surgery (cholecystectomy), your body adapts to digesting fat without a gallbladder.
The liver produces bile and the gallbladder normally acts as a storage reservoir for the bile, releasing it in controlled amounts when you eat. Once the gallbladder is removed, bile flows continuously from the liver into the intestine. This change in bile flow can affect how fats are digested and absorbed.
As a result, some patients experience temporary symptoms such as:
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Loose stools or diarrhoea
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Bloating or excess wind
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Abdominal discomfort after fatty meals
These symptoms are most common in the early weeks after surgery and usually improve as the digestive system adapts.
What to Eat Immediately After Gallbladder Surgery
Immediate postoperative dietary recommendations emphasize early enteral nutrition and a gradual reintroduction of solid foods. Early nutritional intervention improves nutritional status, gastrointestinal recovery, immune function, and reduces postoperative complications.
The recommended progression is as follows: high-protein liquids during the first week, a semi-liquid diet (including mashed vegetables, pureed meats, and broths) for weeks 2–3, and gradual introduction of solid foods from week 4 onward. Small, frequent meals are preferred, and carbonated beverages should be avoided during early recovery to minimize bloating and discomfort.
Long-term dietary guidance focuses on a low-fat, high-fiber diet to minimize gastrointestinal symptoms and metabolic complications. High-fat, high-cholesterol diets are associated with increased risk of gut dysbiosis, intestinal inflammation, and metabolic syndrome after cholecystectomy. Adequate protein intake and regular aerobic exercise are recommended to prevent weight gain and maintain metabolic health. Dietary consultation is beneficial for optimizing outcomes and preventing excessive fat intake, which can worsen lipid profiles and contribute to weight gain.
Why Choose a Specialist Gallbladder Surgeon?
As an experienced upper gastrointestinal and hepatopancreatobiliary surgeon, Dr Carr-Boyd manages the full range of gallbladder, bile duct and liver conditions — from straightforward gallstone surgery to complex cases requiring advanced procedures involving the liver and bile ducts.
Your Surgical Experience
During your consultation we will cover:
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Your symptoms and concerns
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Review of your imaging
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Whether surgery is needed
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What to expect before, during and after surgery
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Risks, benefits, and alternatives
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Recovery times and lifestyle considerations
After surgery You will have:
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A clear recovery plan
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Access to advice if symptoms arise
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Follow-up to ensure you are healing well