Complications After Gallbladder Removal: A Plain-English List

Serious complications after gallbladder removal are uncommon, and many of them show up in the first days or weeks after the operation. The main ones are bleeding, infection, a bile leak, injury to the bile duct, stones left behind and blood clots, with a hernia or a bile duct stone sometimes appearing months or years later.

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Consent forms list many risks with little sense of how likely they are, and afterward it can be hard to tell whether an ache, a fever or a bulge is a complication or simply part of healing.

This guide lists the complications of the operation itself, how common each is, when it tends to appear and which symptoms mean a call to your surgeon or emergency help.

What Complications Can Happen After Gallbladder Removal?

The main complications that can happen after gallbladder removal include bleeding, infection, a bile leak, injury to the bile duct, gallstones left in the duct or spilled in the abdomen, fluid collections, blood clots, problems from the anesthetic and, later, a hernia at an incision or trouble from scar tissue [1, 2, 3]. In a pooled analysis of 151 studies and more than 500,000 people having keyhole surgery, the overall complication rate was 1.6 to 5.3 percent, and deaths were 0.08 to 0.14 percent, or roughly 1 in 1,000 [4].

Those figures vary with who is having surgery and how complications are counted: in 13,651 people in Italy, 2.0 percent had a surgical complication within 30 days and 2.1 percent one elsewhere in the body [5]. Among US Medicare patients admitted to hospital for keyhole surgery, whose average age was 75 and nine in ten of whom were unplanned admissions, 16.5 percent had a complication of some kind in 2021 and 7.0 percent a serious one [6]. Rates are also higher after open surgery [5, 2], and a keyhole operation is switched to open in about 4 to 6 percent of cases [4], more often with an inflamed gallbladder, age over 60, previous upper abdominal surgery or male sex [7].

Is It a Complication or a Normal Part of Recovery?

Many symptoms in the first weeks are expected parts of recovery, as our gallbladder removal recovery guide explains. Belly pain that spreads to the shoulders comes from gas left in the abdomen after keyhole surgery and should ease over several days to a week [8]. By day 4 most people report no severe pain, incision pain is usually gone in 7 to 10 days, and a small amount of drainage from an incision is normal [2].

Nausea in the first days, a sore throat from the breathing tube and loose stools after meals for four to eight weeks are also expected [8, 9]. Liver blood tests often rise for a day or two and are usually back to baseline within a week [10], and a small amount of fluid where the gallbladder sat can be a normal finding on scans [3].

The difference is usually direction: expected discomfort tends to ease each day, while a complication tends to bring pain, fever or swelling that builds instead of easing [2, 8].

Complications of Gallbladder Surgery: A Plain-English List

1. Bleeding

Bleeding can come from small vessels in the bed where the gallbladder was attached, or from the stump of its artery if a clip or tie slips [3]. Among Medicare patients in 2021, bleeding during the operation was recorded in about 0.5 percent and 1.9 percent needed a transfusion [6]. Bleeding inside the abdomen afterward may cause belly pain and swelling, dizziness, clammy skin or a racing pulse, and needs emergency help [11].

2. Wound and abdominal infection

Pooled data from 84 studies put wound infection after keyhole surgery at about 1.25 percent [4], and in the American College of Surgeons' sample risk figures it affects about 1.0 percent after laparoscopic removal and 7.0 percent after open surgery [2]. Call about an incision that is red and warm, bleeding, or has thick yellow or green drainage [8]. Fever, chills or belly pain that builds can point to a deeper infection, such as an abscess, and are reasons to call your surgeon [2].

3. Bile leak

A bile leak happens when bile escapes into the abdomen, most often from the stump of the cystic duct, which connected the gallbladder to the main bile duct [12]. It can also come from tiny ducts in the liver bed, and the risk is higher when the gallbladder was severely inflamed or only partly removed [3]. Pooled data put leaks at about 0.5 percent, a Swedish analysis at 1.5 percent [4].

A leak usually shows itself as belly pain, sometimes with a swollen belly, fever or yellowing of the skin [3, 2]. Treatment is usually a small stent placed by ERCP, a scope passed through the mouth; in nine studies of people treated this way, the leak closed in 81 to 100 percent [13].

4. Bile duct injury

An injury to the main bile duct is rare, but surgeons regard it as the most feared complication [4], and a major injury can need surgery to reconnect the duct to the intestine [3]. Reviews and guidelines still quote an estimated 0.4 to 1.5 percent [14, 3], but pooled study rates fell to about 0.2 percent by 2010 to 2015 [4], and to 0.12 percent among Medicare patients in 2021 [6]. Most injuries are found during the operation or soon after, but some come to light later [14]: the American College of Surgeons describes problems appearing from a week to six months after surgery, with fever, pain, jaundice or bile leaking from an incision [2].

5. Stones left in the bile duct

A stone may already be in the common bile duct at the time of surgery and be missed, or a new one may form there later [9]. Bile duct stones are found days to years after surgery in up to 5 percent of people [15]. One that blocks the duct causes upper abdominal pain lasting at least 30 minutes, sometimes with fever, yellowing of the skin or clay-colored stools, and it can lead to infection of the duct or pancreatitis [16]. Our article on gallstones without a gallbladder explains more.

6. Spilled or dropped gallstones

If the gallbladder tears during keyhole surgery, stones can fall into the abdomen. This is reported in 1 to 40 percent of operations [17] but rarely causes trouble. Estimates of how often problems follow vary widely, and half or more of those that occur are abscesses [3, 17, 18]. In published cases, symptoms began anywhere from the second day after surgery to 15 years later [18].

7. Fluid collections

A small pocket of fluid, or even a little blood, in the gallbladder bed is expected and usually stays the same size or shrinks [3]. A large or growing collection raises concern for a pool of bile from a leak, bleeding or an abscess [3]. Those that cause fever or pain may be drained through the skin with a thin tube guided by a scan [3].

8. Blood clots in the legs or lungs

Estimates for a clot in a deep vein or the lungs after keyhole gallbladder surgery range from under 0.1 percent within four weeks in a large pooled analysis [19] to about 1 percent in the American College of Surgeons' sample figures [2]. The risk is highest in the first 30 days, especially after an emergency operation, and higher at age 70 or over, with a body mass index above 30, and after open surgery [20]. Walking about five times a day and wearing support stockings reduce it [2].

A leg clot can cause swelling, pain, warmth or redness in one leg, though about half of people with one have no symptoms [21]. A clot in the lung can cause trouble breathing, chest pain that worsens with a deep breath, a fast heartbeat or fainting, even with no leg symptoms first [21].

9. Problems from the anesthetic

Nausea and vomiting after an anesthetic affect up to 30 percent of surgical patients and up to 80 percent of those at high risk [22]. Anesthesia and pain medicine can leave you forgetful or tired for two or three days, and some older men have trouble passing urine after a catheter comes out, which is worth telling your surgical team [2].

10. A hernia at a port site

A hernia can form where an instrument went through the abdominal wall. Reported rates range from 0 to 5.2 percent, and 82 percent occur at the belly button [23]. One type appears months after surgery, usually as a bulge that gets bigger when you strain, cough or lift, while an early type can trap a loop of bowel soon after the operation [24, 25]. A bulge that turns painful, cannot be pushed back in, or turns red, purple or dark needs care right away [25].

11. Adhesions

Adhesions are bands of scar-like tissue inside the abdomen, and most people who have them never have symptoms [26]. In a review of more than 446,000 abdominal operations, a bowel blockage from adhesions followed 0.2 percent of laparoscopic and 7.1 percent of open gallbladder removals [27]. A blockage causes abdominal pain, bloating, vomiting and being unable to pass gas, and needs medical help right away [26].

12. Surgical clips that move

The small clips that close the cystic duct and artery normally stay in place, but rarely one migrates into the bile duct, where it can cause infection or become the core of a new stone [3]. One case report describes this 18 years after surgery, with the clip, inside a stone, removed by ERCP [28].

How Long After Gallbladder Surgery Can Complications Occur?

Complications can occur from the day of surgery to years later, though several urgent ones cluster in the first weeks:

• The operation and the next few days: bleeding during surgery [6], then nausea, fogginess and trouble passing urine [22, 2]
• The first weeks: wound infections and bile leaks [3], and the highest risk of blood clots in the first 30 days [20]
• A week to six months: sometimes, a bile duct injury or leak that was not obvious at first [2, 14]
• Months to years: a port-site hernia [24], trouble from spilled stones [18] or adhesions [26], a migrated clip [28] and new bile duct stones, which one series found a mean of about eight years after surgery [29]

What Are the Signs of Complications After Gallbladder Surgery?

The signs of complications after gallbladder surgery are pain, fever, swelling or vomiting that gets worse rather than better, problems at an incision, yellowing of the skin, and the symptoms of a clot. Call your surgeon if you have [2, 8]:

• a fever over 101°F, or chills
• belly pain or swelling that will not go away, gets worse or is not helped by your pain medicine
• redness that spreads, swelling or bleeding at an incision, or bad-smelling, thick, yellow or green drainage
• a dressing soaked with blood
• vomiting that continues, or being unable to keep fluids down
• yellowing of your skin or eyes, or gray stools
• a cough that does not go away
• no bowel movement two to three days after the operation
• swelling, pain or redness in one leg [21]

Get emergency medical help right away if you have [21, 11, 26]:

• chest pain, trouble breathing or coughing up blood, even with no leg symptoms
• fainting, a racing heartbeat, or feeling lightheaded, pale and clammy, especially with belly pain or swelling
• vomiting with abdominal pain and being unable to pass gas

What Are the Long-Term Effects of Gallbladder Removal?

The long-term effects of gallbladder removal are mostly changes in digestion rather than complications of the operation, and most people live a healthy life without a gallbladder [9]. Because bile now flows from the liver straight into the intestine [30], about 13 percent develop new diarrhea in pooled studies [31]. Others notice bile reflux [32], or the pain and indigestion called post-cholecystectomy syndrome, estimated from about 3 percent in a 2026 pooled analysis [33] to 5 to 30 percent in StatPearls [34]. Our guide to the side effects of gallbladder removal covers these, as do our articles on post-cholecystectomy syndrome, diarrhea and bile reflux.

If rich meals leave you feeling heavy, smaller and more frequent meals come first [35]. Dr.Primal's TUDCA is made for life after gallbladder removal and taken with meals, when your body calls on bile the most. It is a hydrophilic, or water-loving, bile acid that occurs naturally in small amounts in human bile [36], used to support healthy bile flow and fat digestion.

Liver tests that rise in the first days are usually back to baseline within a week [10], so abnormal results months later need a cause found, such as a bile duct stone [37]. Our article on the liver without a gallbladder sets out the research.

In Summary: Complications After Gallbladder Removal

Complications after gallbladder removal are uncommon, at roughly 2 to 5 percent after keyhole surgery in a large pooled analysis, and higher after open surgery and in older, sicker patients having unplanned operations. Bleeding, infection, leaks and clots tend to appear in the first weeks, and a hernia or new duct stones months or years later. Symptoms that worsen instead of settling are the common thread.

If your symptoms are digestive rather than surgical, our short digestion quiz is a quick way to put your symptoms and habits in order, and our questions to ask your doctor can help at your next appointment.

This article is for general education and is not a substitute for advice from your doctor. TUDCA is sold as a dietary supplement. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.