By Dr Thomas Hanna MBChB, FRCS, MSc, PGCE, PhD and Dr Peter Swan MBChB, FRACS
Compass Surgical | MacMurray Centre, Auckland
This is the sixth article in our 8-part guide to gallstones and gallbladder surgery.
In our previous article, we explained what happens during a laparoscopic cholecystectomy and what patients can expect on the day of surgery. A natural follow-on question is:
“How safe is gallbladder surgery?”
The short answer is reassuring.
Laparoscopic gallbladder removal is one of the most commonly performed operations worldwide and is generally considered a safe and effective treatment for symptomatic gallstones. The overwhelming majority of patients recover without experiencing any significant complications.
However, no operation is completely risk-free, and understanding those risks is an important part of making an informed decision about treatment.
Modern laparoscopic techniques have transformed gallbladder surgery.
Compared with traditional open surgery, laparoscopic surgery is associated with:
Most patients return home the same day or after a single overnight stay and recover steadily over the following weeks.
While surgeons spend time discussing uncommon complications during the consent process, it is important to remember that most patients experience a straightforward recovery.
Like any operation, gallbladder surgery carries some general surgical risks.
These include:
Bleeding
Minor bleeding during surgery is common and carefully controlled.
Significant bleeding requiring transfusion or additional surgery is uncommon.
Infection
Infection can occur in the wounds or within the abdomen.
Most infections are minor and respond well to antibiotics or simple treatment.
Blood Clots
All surgery slightly increases the risk of blood clots forming in the legs or lungs.
Early mobilisation, compression devices and careful perioperative care help minimise this risk.
Anaesthetic Risks
Modern general anaesthesia is extremely safe, although complications can occasionally occur.
Your anaesthetist will discuss any individual risks before surgery.
Certain complications are unique to gallbladder removal.
Bile Leak
After the gallbladder has been removed, bile can occasionally leak from small ducts within the liver bed or cystic duct stump.
This is uncommon but may require:
Retained Bile Duct Stones
Occasionally a stone remains within the bile duct despite successful gallbladder removal.
This can cause pain, jaundice or abnormal liver tests and may require treatment with ERCP.
Working within the MacMurray Centre allows us to collaborate closely with experienced gastroenterologists when these situations arise.
Injury to Nearby Structures
Structures close to the gallbladder include:
Injury to these structures is uncommon but may occasionally require further treatment or surgery.
When patients research gallbladder surgery online, this is often the complication that causes the greatest concern.
A bile duct injury occurs when the main drainage system carrying bile from the liver is inadvertently damaged during surgery.
Fortunately, this complication is uncommon.
However, when it occurs it can be serious and may require:
One of the most important advances in modern gallbladder surgery has been the routine use of the Critical View of Safety technique.
This internationally recognised approach helps surgeons correctly identify the anatomy before any structures are divided and has become a cornerstone of safe laparoscopic cholecystectomy.
At Compass Surgical, patient safety remains the highest priority throughout every operation.
Occasionally, yes.
Most gallbladder operations are completed laparoscopically, but severe inflammation, scarring, bleeding or unexpected findings may make conversion to an open operation the safest option.
This is not considered a complication or a failure.
Rather, it is a surgical judgement made in the patient’s best interests when continuing laparoscopically would increase risk.
Good surgical judgement includes recognising when it is safer to modify the procedure or change course in the interests of patient safety.
Safe gallbladder surgery begins long before the operation itself.
At Compass Surgical, we minimise risk through:
Every patient is different, and factors such as previous surgery, severe inflammation, obesity or complex anatomy are considered when planning treatment.
Every treatment decision involves balancing risk.
For patients with recurrent gallstone symptoms, the risks of ongoing gallstone disease often outweigh the relatively small risks associated with elective surgery.
At Compass Surgical, informed consent is a process rather than a signature on a form.
During consultation we discuss:
All patients also receive the Royal Australasian College of Surgeons (RACS) patient information sheet on gallbladder surgery, which reinforces the information discussed during consultation and provides additional guidance about the procedure and its recognised complications.
Compass Surgical was founded on a simple principle:
Do the right operation, for the right patient, at the right time.
Our practice is built around:
We believe discussing risks openly is an essential part of good surgical care.
The goal is not simply to minimise risk.
The goal is to ensure every patient understands the risks, benefits and alternatives so they can make decisions confidently and with realistic expectations.
If you would like to learn more about gallbladder surgery or discuss your individual risks and treatment options, visit the Compass Surgical Gallbladder Surgery page or arrange a consultation with one of our surgeons.
Fortunately, most patients never experience these complications and recovery is usually straightforward.
The next question is often a practical one:
“How long will it take me to recover?”
In the next article, “How Long Does Gallbladder Surgery Recovery Take?”, we’ll discuss what recovery actually looks like after surgery, including pain, returning to work, driving, exercise and getting back to normal activities.
Is gallbladder surgery safe?
Yes. Gallbladder surgery is generally considered very safe and is one of the most commonly performed operations worldwide.
What is the most serious complication?
The most significant recognised complication is injury to the bile duct, although this remains uncommon.
How common are complications?
Most patients recover without experiencing significant complications. Individual risk varies depending on the patient and the complexity of the surgery.
What happens if a complication occurs?
The appropriate treatment depends on the specific complication and may involve imaging, endoscopy, medication or occasionally further surgery.
Will my risks be discussed before surgery?
Absolutely. Risks, benefits and alternatives are discussed carefully during consultation, and all patients receive the RACS patient information sheet as part of the informed consent process.
Need Advice About Gallbladder Surgery?
If you are considering gallbladder surgery and would like personalised advice regarding the risks, benefits and alternatives, Compass Surgical can help.
Working closely with your GP and the multidisciplinary team at the MacMurray Centre, we pride clear, evidence-based advice tailored to your individual circumstances.
Understanding risk is an important part of good surgical care, and our goal is to ensure every patient feels informed, supported and confident in their decision-making.
Contact Compass Surgical to arrange a consultation.
Article 1 of 8 – What Are Gallstones and What Symptoms Do They Cause?
Article 2 of 8 – Do Gallstones Go Away Without Surgery?
Article 3 of 8 – What Is Biliary Dyskinesia?
Article 4 of 8 – What About Gallbladder Polyps?
Article 5 of 8 – What Is Laparoscopic Gallbladder Surgery?
Article 6 of 8 – What Are the Risks of Gallbladder Surgery?
Article 7 of 8 – Recovery After Gallbladder Surgery
Article 8 of 8 – Why Your Follow-Up Appointment Matters After Gallbladder Surgery?
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Dr Thomas Hanna MBChB, FRCS, MSc, PGCE, PhD
Dr Thomas Hanna is a general and transplant surgeon practising in Auckland. He trained in the United Kingdom before moving to New Zealand in 2019. He has specialist interests in gallbladder surgery, hernia repair, minimally invasive surgery and complex abdominal surgery. Tom is a founding partner of Compass Surgical and is committed to patient-centred surgical care, clear communication and surgery performed with integrity.
Dr Peter Swan MBChB, FRACS
Dr Peter Swan is a general surgeon practising in Auckland with expertise in gallbladder surgery, hernia repair and general surgical conditions including lumps and bumps. He is a founding partner of Compass Surgical. Peter’s practice focuses on practical, evidence-based advice, careful patient selection and personalised treatment.
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Compass Surgical
Doing what’s right, always.
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