Complications of gallstones

Photo of a man with bad abdominal pain
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Gallstones are quite common in people over the age of 40. But most people don't notice them because the stones don't cause any symptoms. Treatment is usually only a good idea if there are noticeable symptoms. This is because that means there is a greater risk of complications.

The possible complications of gallstones include of the gallbladder, bile duct or pancreas and obstruction of the bowel. Very large gallstones may increase the risk of gallbladder cancer and bile duct cancer. Each year about 1 out of 100 people who have typical gallbladder symptoms such as colic develop complications.

Inflammation of the gallbladder (cholecystitis)

The gallbladder can become inflamed if a gallstone prevents bile from draining properly. The fluid builds up and stretches the gallbladder wall, irritating the lining of the wall. Bacteria can easily grow on the irritated, inflamed lining. The signs of an acute include persistent, severe pain in the right upper abdomen, fever and chills. The right upper abdomen hurts when touched, and feels tight. The pain radiates into the right shoulder. Inflammation of the gallbladder may be acute or chronic, or clear up on its own and then come back again.

An acute may lead to further complications, particularly if left untreated. Pus might form inside the gallbladder, the organ could die, or the may spread to neighboring organs. If the spreads to the blood and then to the entire body, it is called septicemia. Septicemia has to be treated immediately.

In very rare cases a chronic may cause what is known as "porcelain gallbladder," with a thickened and calcified gallbladder wall. Then the gallbladder can no longer contract (squeeze out bile) properly. A certain type of porcelain gallbladder with patchy calcifications increases the risk of getting cancer of the gallbladder: It is estimated that 7 out of 100 people with this kind of porcelain gallbladder get gallbladder cancer.

Acute inflammation of the bile duct (cholangitis)

Inflammation of the bile duct also leads to severe pain in the upper abdomen, fever and chills, and sometimes to jaundice too. Like a gallbladder , it can spread to neighboring organs and lead to complications, some of them severe.

Inflammation of the pancreas (pancreatitis)

Pancreatitis is a very rare, serious disease. It leads to severe pain in the upper abdomen, as well as nausea, vomiting and fever. It is most commonly caused by bile duct stones. A stone lodged in the common bile duct can block the duct opening that is shared by the gallbladder and pancreas. Then the digestive juices produced in the are unable to drain, and attack the itself. Pancreatitis is a potentially life-threatening disease, particularly if it is treated too late or not treated properly. But full recovery is usually possible given the right treatment.

Gallbladder cancer and bile duct cancer

Gallstones increase the risk of gallbladder cancer and bile duct cancer. These types of cancer are rare, though: It is estimated that 5 out of 1,000 people with gallstones get gallbladder cancer. People with very large gallstones and porcelain gallbladder have a higher risk than people with other types of gallstones. In Germany, a total of about 5,000 people get gallbladder cancer or bile duct cancer each year.

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Deutsche Gesellschaft für Verdauungs- und Stoffwechselerkrankungen (DGVS), Deutsche Gesellschaft für Viszeralchirurgie (DGVC). Diagnostik und Therapie von Gallensteinen. S3-Leitlinie. July 2007. (AWMF-Leitlinien; volume 021 - 008).

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Robert Koch-Institut (RKI), Gesellschaft der epidemiologischen Krebsregister in Deutschland e.V. (GEKID). Krebs in Deutschland 2011/2012. Berlin: RKI; 2015.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Updated on February 8, 2017
Next planned update: 2021


Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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