An inflamed gallbladder, called cholecystitis, is almost always treated with surgical removal of the gallbladder. While antibiotics and pain management can calm the inflammation short-term, surgery is the definitive treatment because the condition tends to come back. The sooner it’s addressed after symptoms begin, the better the outcomes.
What Happens During an Episode
Gallbladder inflammation usually starts when a gallstone gets stuck in the duct that drains the gallbladder. Bile builds up, the gallbladder swells, and infection can set in. The hallmark symptom is intense pain in the upper right side of your abdomen, often after eating a fatty meal. Fever, nausea, and vomiting are common. The pain typically lasts longer than a standard gallstone attack, persisting for hours rather than passing within 30 to 60 minutes.
If your belly pain is so severe that you can’t sit still or find a comfortable position, you need emergency care. Untreated cholecystitis can cause the gallbladder tissue to die (gangrene) or the gallbladder to rupture. These complications are life-threatening and most commonly affect older adults, people with diabetes, and those who delay treatment.
Initial Hospital Treatment
When you arrive at the hospital with an inflamed gallbladder, the first goal is to stabilize you. That means IV fluids, pain medication, and nothing by mouth to let the gallbladder rest. Antibiotics are started to fight or prevent infection. The Surgical Infection Society recommends keeping antibiotic treatment to a maximum of four days, and often shorter, for patients heading into surgery. These medications control the infection but don’t fix the underlying problem.
Surgery: The Standard Treatment
Gallbladder removal is the standard and most effective treatment. Outcomes are better when surgery happens soon after hospital admission rather than being delayed for weeks. There are two approaches.
Laparoscopic Removal
This is the most common method. The surgeon removes the gallbladder through several small incisions in the abdomen using a camera and specialized instruments. Most people go home the same day. Full recovery takes about a week, and you can typically return to work within one to two weeks.
Open Surgery
In this approach, the gallbladder is removed through a larger incision on the right side under the ribcage. It’s used when the laparoscopic approach isn’t safe, often because of severe inflammation, scarring, or complications discovered during the procedure. Conversion from laparoscopic to open surgery happens in roughly 1 to 7.5% of elective cases, and the rate is higher during acute inflammation. You’ll stay in the hospital for one to two days, and full recovery takes four to six weeks.
When Surgery Isn’t an Option
Some people are too sick for surgery because of heart disease, lung problems, or other serious conditions. In these cases, doctors can place a drainage tube through the skin and into the gallbladder to release the infected bile. This procedure resolves the acute episode about 91% of the time. However, it comes with significant tradeoffs: nearly half of patients experience problems with the drain, and about 28% need a follow-up procedure. Seven percent develop complications directly related to the drainage itself. It’s a bridge to get through a crisis, not a long-term solution.
Recovery After Gallbladder Removal
Your body adjusts to life without a gallbladder by routing bile directly from the liver into the small intestine instead of storing it. This works well for most people, but the adjustment period matters.
For at least a week after surgery, avoid high-fat foods, fried foods, and fatty sauces or gravies. When checking labels, low-fat means no more than 3 grams of fat per serving. Focus on lean protein like poultry, fish, or fat-free dairy alongside vegetables, fruits, and whole grains. Caffeine, dairy products, and very sweet foods can worsen diarrhea during this period, so it helps to limit those as well.
Your tolerance for fat gradually improves over weeks to months. Most people eventually eat a normal diet without issues, though some find that very rich or greasy meals still cause loose stools long-term.
Ongoing Symptoms After Removal
About 10 to 15% of people develop digestive symptoms after gallbladder removal, sometimes called postcholecystectomy syndrome. These symptoms fall into two categories. In the upper digestive tract, the continuous flow of bile (no longer stored and released in batches) can irritate the stomach lining or esophagus, causing heartburn or nausea. In the lower digestive tract, the steady bile flow can trigger diarrhea and crampy lower abdominal pain.
The good news is that most of these symptoms are mild. One large study found that 65% of patients had no symptoms at all after surgery, 28% had mild symptoms, and only 2% had severe ongoing problems. In studies tracking whether patients felt better or worse compared to before surgery, about 62% reported less severe symptoms than they had before the operation. For the small number who do have persistent trouble, dietary adjustments and medications that bind excess bile in the gut can help considerably.