Pain after biliary surgery


Temporary pain is common after biliary surgery. There can be various reasons for this. In most cases these are side effects of the healing process. In rarer cases, however, the pain can also be a sign of possible complications, such as infection or impaired wound healing. The attending physician will explain any pain that can occur naturally. However, if the symptoms are very severe or if they continue to increase, the doctor should be consulted again and asked for advice.

Learn more about this topic: Pain after surgery


During a gall bladder operation, various tissue structures in the body must be severed in order to reach the gall bladder and operate on it. This naturally leads to temporary pain until the body has repaired the damage as part of the healing process. However, every operation can also lead to complications, which are often initially expressed in pain. These include, for example, inflammation in the surgical area or the skin wounds or bleeding. Furthermore, completely different causes can lead to pain that are not directly related to biliary surgery. Particular mention should be made of back pain or muscular tension.

Also read our topic: Post-operative pain

Measures to reduce pain

In order to treat the pain after the gallbladder has been surgically removed, pain medication is usually given in the hospital. Often it is the drug Novalgin® or the active ingredient metamizole. The pain reliever is usually first given as an infusion, i.e. via a drip. After usually a day or two, the remedy is switched to tablets or drops to be swallowed. If the pain is normal, it treats the pain well and becomes less severe over the course of a few days. The pain reliever can then be slowly withdrawn. However, if the pain does not subside, cannot be treated by the pain reliever or even increases further, further therapy may have to be given. When a complication like a

Wound healing disorder or infection is the cause of the excessive pain, appropriate treatment must be given. This may mean prescribing antibiotics and, in very rare cases, reoperation.

How long does the pain last?

Pain after gallbladder surgery that lasts for a few days to a week is normal. As a rule, the pain gets a little better every day until it has completely subsided. However, if the pain is still severe after a week or if it recurs after a temporary improvement, a doctor should be consulted. This also applies to the occurrence of other symptoms such as fever, nausea, vomiting, circulatory problems or yellowing of the skin.

You can either contact your family doctor or you can go straight to the hospital where the operation was performed. If pain in the upper abdomen only occurs after a few months or years, a connection with the biliary operation is rather unlikely. Even if it may be adhesions as a result of the operation (adhesions in the abdomen), other triggers such as radiating back pain or stomach problems are much more common.

Localized pain

Pain especially on the right side

The upper right abdomen is the point on the body where the pain emanating from the gallbladder is most commonly felt. The organ is located in this part of the abdomen in direct proximity to the liver and is fused with it. Surgical removal of the gallbladder causes wounds in the abdomen that have to heal first. This then leads to the pain in the upper abdomen after the operation. These can also radiate into other areas of the right side of the body, especially the right shoulder.

Pain in the upper abdomen

It is not uncommon for pain to occur after biliary surgery. In most cases this is pain in the course of the healing process after the operation - after all, tissue was severed and / or injured by removing the gallbladder. The pain is mostly concentrated in the area of ​​the right upper abdomen where the gallbladder was located under the liver before it was removed. It is not uncommon for this right-sided upper abdominal pain to also radiate into the right shoulder, which is due to a special neuronal circuit between the pain fibers of the liver / gallbladder area and the skin in the right shoulder area.

You should only pay attention if this pain persists or is accompanied by other symptoms such as fever, circulatory disorders, nausea and vomiting, peritonitis or yellowish discoloration of the skin. If this is the case, it should always be taken into account that it could be postoperative complications, such as B. infections in the area of ​​operation or the surgical wound, leaks from the severed bile duct or the gallbladder vessel with subsequent leakage of bile fluid or blood into the abdominal cavity and a bile duct obstruction by gallstones from the liver.

Back pain

Back pain that occurs soon after the gallbladder has been surgically removed, for example, can be caused by the positioning during the operation and the long time you have to lie in bed. In the course of recovery and with careful resumption of everyday activities, the pain usually subsides. In addition, pain from the operating area can also radiate into the back. If the back pain is delayed for a few days or weeks, it can be a sign of a complication, such as an inflammation or the beginning of adhesions. However, other causes of back pain are more common, such as muscle tension or nerve irritation.

cramping pain - what can it be?

Pain that is cramp-like and does not occur until some time after a biliary operation, seen in connection with this operation, can be an indication of adhesions. In the course of the operation, injuries to various structures in the liver and gallbladder area inevitably occurred, which have healed over time. Healing always means scarring, so that adhesions can also occur in the area of ​​the right upper abdomen.

If there was previously an inflammatory change in the area of ​​the gallbladder over a certain period of time, then adhesions have again favored this. If such adhesions are present, there is always the risk of intestinal entrapment, which can be expressed in cramp-like abdominal pain. If these occur and cannot be clearly related to another cause, a doctor should be consulted promptly in order to rule out this late complication or, in the worst case, treat it in good time.

Painful breathing

As with any surgical procedure, pain can also occur after biliary surgery. Patients often complain of pain, especially when breathing. When you inhale, the diaphragm moves down the body and pushes the liver down. The gall bladder is located in close proximity to the liver, so that after the organ has been surgically removed, the surgical area can be displaced and thereby irritated when inhaling. Many patients respond by making their breathing easier to avoid pain. In such a case, however, the pain medication should be temporarily increased by the doctor so that the patient can breathe deeply. Another possible cause of pain after biliary surgery, which occurs particularly when breathing, is a consequence of the minimal surgical operation method (laparoscopy) itself. During the operation, the abdominal cavity is inflated with a gas, which is then released again. However, some of the gas can temporarily remain in the abdomen and thus be responsible for the pain when breathing. However, the gas is soon reabsorbed by the body without any consequences.

Pain in the diaphragm

To relate the pain specifically to the diaphragm as the triggering location is actually not possible. However, if you still have the feeling after a biliary operation that the pain that still persists is coming from this area, the liver, which is located directly under the diaphragm, is usually behind it: the liver is encased in a capsule with sensitive nerve fibers is supplied. Whenever the liver is injured or the capsule is under tension, we perceive it as pain in the right upper abdomen or even in the right shoulder.

During a gall bladder operation, the gallbladder is peeled from its bed below the left lobe of the liver, separated from its supply structures (bile duct and gallbladder blood vessel) and removed from the body. This always creates a wound in the liver bed, which is responsible for the pain until it heals. Especially when breathing, when the diaphragm moves and these movements are transferred to the underlying organs (such as the liver), the pain can be provoked and / or worsened, so that the impression can be given that the diaphragm itself is painful.

Pain in the navel

Pain in the navel after biliary surgery is not uncommon. A so-called minimally invasive surgical procedure (also known as a laparoscopic called). Various small instruments are inserted through small incisions in the abdomen. One of these approaches is usually through the navel. Ultimately, the removed gallbladder is usually retrieved via this access route at the navel. Depending on the size of the organ, something must be pulled and stretched. This stress can explain the pain in the navel. However, these usually go away within a few days. However, if the pain persists or recurs after it has improved, the attending physician or family doctor should be consulted.

Pain after the wound has healed

If a little time has passed, the surgical wounds have healed and the scarring is complete, then the pain in the area of ​​the right upper abdomen should also disappear, as this was actually only an expression of the healing process. However, if pain recurs after a certain time, this can have various causes, which can be more or less serious.

Even if the gallbladder, as a collecting reservoir for bile and gallstones, is no longer available, gallstones may still be formed, which can obstruct the remaining bile ducts. Gallstones can also develop in the bile ducts of the liver, which then clog the ducts and lead to bile congestion with pain in the right upper abdomen.

As part of the healing process, adhesions can also always occur in the abdomen, which can be accompanied by abdominal pain. If the pain occurs soon after the operation, it must always be remembered that there may be a leak in the severed bile duct leading to the gallbladder and bile fluid escaping into the abdominal cavity, which can then lead to peritonitis.

Accompanying symptoms of pain after biliary surgery

In addition to pain, after a biliary surgery there may be other symptoms that are either naturally caused by the operation, but can also indicate a complication. In the days after the operation, many patients complain of tiredness and exhaustion, which are caused on the one hand by the general anesthesia and on the other hand by the temporary weakening of the body. Often there are also temporary indigestion, especially constipation.


In the event of pain after biliary surgery, the most important basis for making a diagnosis is a medical consultation in conjunction with a physical examination. From the patient's information on when the pain occurs, what character it is (for example dull, wavy or stabbing) and possible accompanying symptoms, the doctor can in most cases already assess whether this is normal pain in the context of wound healing after the Surgery or whether there could be a complication. A wound healing disorder can be identified, for example, by increased redness, swelling and possibly pus formation. A determination of the inflammation and bile values ​​in the blood can also provide information about the cause of the pain. Depending on the doctor's assessment, a more detailed examination, for example using ultrasound, may be appropriate to establish the diagnosis.

You might also be interested in this topic: Complications after surgery


Pain can occur after biliary surgery, but this can usually be alleviated or at least reduced by the painkillers administered routinely. After the structures injured by the operation, such as the abdominal wall, have healed, the pain usually disappears again. Even if complications such as inflammation occur, the pain usually subsides within a few days to a maximum of a few weeks with appropriate medical treatment. In very rare cases, long-term pain as a result of biliary surgery is possible, which may then have to be treated with painkillers.