A stone gave me pancreatitis and I spent five days on a ward. Do I really have to have the gallbladder out now, when the pain has gone?

Some of you might remember me from last autumn, three stones found by accident on a scan, GP said leave them, everyone here very sensibly told me not to panic. Well. Two weeks ago I woke up at about 4am with a pain in the middle of my upper stomach that went straight through to my back, and I could not lie flat, could not sit still, could not do anything except be sick repeatedly. Ended up in A&E and then on a ward for five days with gallstone pancreatitis.

Here is my problem. I feel FINE now. Genuinely fine, eating normally, back at work. And the surgical team have written to me about taking the gallbladder out reasonably soon, and part of my brain is going, hang on, the stone has clearly gone, the pancreas has calmed down, why are we now doing abdominal surgery on someone who feels well?

I know what you are all going to say. But I would like to hear it anyway from people who have actually been through this, because the leap from "leave them alone" to "operation in the next few weeks" in eight months is doing my head in.

Oh no. I am so sorry, that sounds horrendous. And no, nobody is going to tell you to leave it.

The thing that changed is not how you feel today, it is what your stones have shown they are capable of. Mine never did that and I still had them out.

Feeling fine afterwards is exactly the trap. The stone that did it has passed on through, so of course the pain stopped, but there are still stones sitting in the gallbladder and nothing whatsoever stopping the next one taking the same route. That is the bit I would keep in your head at 2am.

I had mine out on a planned list and it was three little cuts and home the same day. Would take that any day of the week over another five days on a ward.

Agreeing with the above but I want to say the other bit out loud, because I think it is what you are actually asking. You feel a bit conned. You did the sensible watch and wait thing, you followed the advice, and it still went wrong, so now you are not sure you can trust the next piece of advice either.

That is a completely reasonable way to feel and it is also not what happened. Watch and wait was the right call for the stones you had then. You are now a different case.

To answer the question directly: yes, this is the standard advice, and it is not an overreaction to a frightening admission. Guidelines put gallstone pancreatitis firmly in the group of situations where laparoscopic cholecystectomy is recommended, alongside biliary colic, an inflamed gallbladder and a stone that has passed into the bile duct.

The reasoning is worth setting out, because it also answers why you were told the opposite last year. Silent stones, ones causing no symptoms at all, are usually left alone, and roughly 80% of gallstones are silent. The moment stones cause symptoms the arithmetic changes: from that point people carry roughly a 1 to 4% per year risk of a further complication, and that risk does not reset because an episode has ended. Your stones have not merely become symptomatic, they have caused the complication. The gallbladder is the reservoir that produced the stone that blocked your duct, and it still holds the others. Removing it is what closes that route. What actually happens in gallstone pancreatitis sets it out in full, and silent gallstones explains why the advice you were given last year was right for last year.

Two specifics people always ask next. First, the timing: surgeons generally do not want a long delay after gallstone pancreatitis, because the window in which another stone can make the same journey stays open until the gallbladder is out, and that is why the letter arrived promptly. Second, the stone itself: many pass into the bowel on their own and nothing more is needed, but if bloods or scans suggest one is still lodged in the main bile duct it is cleared separately, often endoscopically. Which of those applies to you is something your team will already know from your admission.

What I will not do is tell you what your own operation should be or when. Take the question of timing, and any worry about how you feel now, to the surgeon who has your notes from that admission in front of them.

Right. That is the sentence I needed, that the risk does not reset because the episode ended. I had somehow decided the danger passed when the stone did.

Clinic in three weeks. Going in with questions rather than an argument this time.

Checking in, how did the appointment go?