Gall Bladder Removal Surgery (cholecystecotomy)

What is gall bladder removal surgery for gallstones?

Small stones usually made of cholesterol that form in the gallbladder are called gallstones. In most cases they do not cause any symptoms. The surgical removal of the gall bladder is not usually required in patients with no symptoms from gallstones.

However, patients with suspected cancer of the gallbladder (carcinoma) or symptoms including intense tummy pain should be treated or referred immediately. Alternative approaches to treatment will usually be recommended including:

• medication for attacks of pain • introducing a low fat diet
• antibiotics for patients with signs of infection.

Treatment is available in the following high risk situations:

• patients with diabetes • patients who have received an organ transplant
• patients with scarring of the liver (cirrhosis) who have been managed conservatively and subsequently develop symptoms
• where there is clear evidence of patients being at risk of cancer of the gallbladder (carcinoma)
• confirmed episode of gallstone induced inflammation of the pancreas (pancreatitis)
• confirmed episode of inflammation of the gallbladder (cholecystitis)
• episode of obstructive yellowing of the skin or whites of the eyes (jaundice) caused by gallstones.

Not normally funded treatment or procedure:

Gall bladder removal for non-troublesome gallstones is not usually funded by the patient’s local NHS commissioning organisation. This is because the majority of patients with gallbladder stones remain without symptom (asymptomatic) and require no treatment. If the patient does not have any symptoms, a policy of ‘active monitoring’ is often recommended. The symptoms which a patient may experience are sudden or intense tummy pain, feeling or being sick, yellowing of the skin or whites of the eyes. In these circumstances the patient should make an emergency appointment to see the patient’s local hospital doctor or GP.

The clinician in charge of the care of the patient’s specific condition, usually a hospital doctor, can assist the application, if there is exceptional clinical need for the treatment to be funded. The patient’s clinician must evidence clinical exceptionality and must be supported by the patient’s local NHS commissioning organisation.

See separate leaflet for more information on Individual Funding Requests (IFRs).

Advice and further guidance:

For more information search ‘gallstones’ at www.nhs.uk

Or to read the ‘gallstone decision aid’ here

Treatment policy for patients covered by NHS Solihull, Birmingham CrossCity and Birmingham South Central Clinical Commissioning Groups.

Download the pdf leaflet here .

Download the Treatment Policy Detail here.

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