How Gallstones Cause Pancreatitis — And Why Early Surgery Is So Important
Nov 27
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Pancreatitis is one of the most painful and dangerous abdominal conditions. One of the most common causes is something surprisingly small: gallstones.
As a general surgeon, I see many patients who don’t realise how quickly a “simple” gallstone can turn into a medical emergency. Here’s an easy explanation of what happens — and why timely surgery matters.
What Are Gallstones?
Gallstones are small, solid deposits that form in the gallbladder. Many people have gallstones without symptoms, but trouble begins when a stone moves toward the common bile duct.
How Gallstones Trigger Pancreatitis
1. A gallstone slips into the bile duct
The bile duct carries bile from the liver and gallbladder into the intestine. It shares a common opening with the pancreatic duct.
2. The stone gets stuck at the junction
This is the critical point. When a stone gets lodged at the ampulla of Vater, it blocks not only bile flow but also the pancreatic juices.
3. Pancreatic enzymes backflow
The pancreas normally releases enzymes in an inactive form. When blocked, these enzymes get activated inside the pancreas itself instead of the intestine.
4. The pancreas starts digesting itself
This leads to inflammation known as acute pancreatitis — a condition that can range from mild to life-threatening.
Why Gallstone Pancreatitis Is Dangerous
It can worsen rapidly in hours.
It may lead to fluid collections, necrosis, infection, breathing problems, kidney injury.
Some patients require ICU care.
Recurrence is extremely common unless the gallbladder is removed.
Why Surgery Is Needed — and Why Sooner Is Better
1. Removes the source of the problem
The gallbladder is where stones form. Removing it (laparoscopic cholecystectomy) prevents future stones from slipping into the ducts.
2. Prevents recurrent pancreatitis
Up to 30–50% of patients may have another episode if the gallbladder is not removed. Each episode can be more severe than the previous one.
3. Recommended by global guidelines
International guidelines strongly advocate early cholecystectomy in the same hospital admission once the acute inflammation settles.
4. Laparoscopic procedure, quick recovery
Most patients go home within 24 hours and live a completely normal life without the gallbladder.
Signs You Should Seek Immediate Medical Help
Severe upper abdominal pain radiating to the back
Persistent vomiting
Fever
Jaundice
Sudden severe abdominal bloating or breathing difficulty
Bottom Line
Gallstone pancreatitis is not something to “wait and watch.”A tiny stone can block a vital duct and spark a dangerous chain reaction. Once stabilized, early gallbladder removal is the safest and most effective way to prevent future attacks.
