Is it a problem to live without a gallbladder? Learn what changes after surgery.

Gallbladder removal surgery, called cholecystectomy, is one of the most common abdominal surgeries in Brazil. It is especially indicated for treating gallstones, commonly known as calculous cholecystopathy. It's estimated that this condition affects up to 20% of the Brazilian population.

A study published in 2024 in the Brazilian Journal of Health Review , conducted by scientists from Brazilian and Bolivian universities, reveals that, between 2019 and 2023, there were 1.3 million hospitalizations related to the problem of patients over 15 years old in the Unified Health System (SUS).

Based on data available on the DATASUS platform, the study also shows that the incidence of cholelithiasis is 3.1 times more frequent in women than in men — of the hospitalizations mapped in the survey, 1,059,926 were among women and 328,213 were among men.

However, despite being part of routine hospital procedures, the procedure still raises the question: how does the body function without a gallbladder? Contrary to popular belief, it's not possible to remove just the stones: it's necessary to remove the entire organ, which stores bile, a substance produced by the liver that aids in the digestion of fats.

The good news is that the body usually adapts well. After gallbladder removal, bile begins to flow continuously into the intestine, even without food intake. "Recovery from cholecystectomy, which may also be indicated in cases of suspected cancer, pancreatitis caused by gallstones, or gallbladder polyps, is generally uneventful and very well tolerated," says digestive system surgeon Victor Edmond Seid of Einstein Hospital Israelita.

Why do gallstones form?

Gallstones arise due to gallbladder malfunction and an imbalance in bile components. Factors such as obesity, changes in cholesterol, rapid weight loss (such as after bariatric surgery), age over 40, multiple pregnancies, and esophageal and stomach surgeries increase the risk of stone formation.

Symptoms include pain in the right side of the abdomen, especially after fatty meals, as well as nausea and indigestion. Even when there are no symptoms, stones can lead to complications such as pancreatitis (inflammation of the pancreas) or cholecystitis (inflammation of the gallbladder), making surgery necessary.

Post-surgical recovery

Some people may experience loose stools or diarrhea in the first few weeks after surgery, especially after prolonged fasting or eating fatty foods. "In most patients with gallstones, the gallbladder is no longer functional, so its removal, which is usually performed laparoscopically in a minimally invasive manner, provides no symptoms, only relief," explains digestive system surgeon Hilton Libanori, also at Einstein.

When diarrhea occurs, it can usually be controlled by spreading meals throughout the day and avoiding long periods without eating. "Few surgery patients report intolerance to very fatty foods. Generally, the opposite occurs, meaning digestion improves," says Libanori.

After the initial recovery period, which includes avoiding high-fat foods and intense physical activity for the first 30 days, most people can return to a normal, unrestricted life.

Source: Einstein Agency

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