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Q: Can I get gallstones again if I had my gallbladder removed?
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Stephen E. Goldfinger, M.D., is the faculty dean for Continuing Education and a professor of medicine at Harvard Medical School. He is a graduate of Columbia College of Physicians and Surgeons, and his clinical base is at the Massachusetts General Hospital.

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July 09, 2008
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A:

It would be highly unlikely for a person to develop gallstones after the removal of the gallbladder.

Stones form within the gallbladder because this organ is the storage place for bile, which flows into it from the liver. There it remains, awaiting the next meal that will stimulate its release into the intestine to help digest fat. Some people form bile that is predisposed to form cholesterol stones when it sits too long within the gallbladder. Such bile is said to be "supersaturated" with cholesterol. A sluggish gallbladder, one that does not contract and empty as briskly as it should in response to a meal, can contribute to the formation of stones.

With the gallbladder removed, the liver empties bile continually into the intestine, so the storage and stasis issues are no longer in play. Mild diarrhea can result from this change in anatomy, but digestion is not really affected in any important way.

It should be mentioned that it is important for the surgeon to be certain that there are no stones in the bile duct that, if left there, might cause symptoms after the operation.

After a cholecystectomy, gallstones can in rare cases develop within bile ducts in people who have a high tendency for stone formation along with unusual bile duct narrowing that retards the flow of bile. But this is quite uncommon.

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