Gallbladder removal in Singapore
Laparoscopic gallbladder removal, done as day surgery in Singapore.
Laparoscopic gallbladder removal, or cholecystectomy, is the standard surgical treatment for gallstones and related gallbladder conditions in Singapore.
FRCSEd (General Surgery)Five clinics in Singapore
In short
Keyhole
How it is done
Laparoscopic cholecystectomy is the standard surgical treatment for gallstones and related gallbladder conditions in Singapore.
Day surgery
Or a single overnight stay
The operation is performed as day surgery or with one overnight stay, and patients are typically discharged within 24 hours.
1 to 2 weeks
Back to light activity
Most patients return to light activities within one to two weeks, and to desk work within five to seven days.
Claimable
MediSave and Integrated Shield
The procedure is MediSave claimable and covered by most Integrated Shield Plans, with pre-authorisation arranged before your surgery date.
His story
Dr Sulaiman Bin Yusof
Senior Consultant Colorectal and General Surgeon, seeing patients at five clinics in Singapore.
- MBChB (Sheffield), M.Med (Surgery), FRCSEd (General Surgery)
- Consults in English and Malay
- MOH Fellowship, Peter MacCallum Cancer Centre, Melbourne
- Singapore Health Quality Service Star Award 2023
- Dean's Honour Roll for Teaching
What to know before the operation
What to know before the operation
45 to 90
Minutes in theatre
How long a laparoscopic gallbladder removal usually runs in theatre. Most patients are discharged the same day or after a single overnight stay, and go home with three or four small dressings rather than one long wound.
Source: Dr Sulaiman Bin Yusof, clinical practice
Asleep
General anaesthesia, with vital signs monitored
Three or four small cuts
Each less than a centimetre across
The gallbladder comes out
Lifted into a bag and drawn through one incision
Closed, and home
Same day, or after a single night
Gallstones cannot be dissolved with medication, and dietary change will not remove stones that have already formed.
3 to 4
Incisions, each under 1cm
The number of keyhole incisions the operation needs, against the single 5 to 7cm incision an open cholecystectomy requires. Less tissue is disturbed, which is the reason the rest of the recovery is shorter rather than a separate benefit of its own.
Source: Dr Sulaiman Bin Yusof, clinical practice
4 to 6 weeks
Back to a full normal diet
Once the gallbladder is gone, bile flows directly from the liver into the small intestine. Fatty, fried and greasy food is avoided for the first one to two weeks, then the normal diet is reintroduced gradually over the weeks that follow.
Source: Dr Sulaiman Bin Yusof, clinical practice
When surgery is needed
Gallstones announce themselves after a meal, and then go quiet again.
Gallstones typically cause sudden, severe pain in the upper right abdomen. The pain often begins 30 to 60 minutes after a fatty meal and may radiate to the right shoulder or upper back. Some people carry gallstones for years without any symptoms. Others experience repeated attacks that become more frequent or more severe over time.
Pain with fever, chills, or yellowing of the skin or eyes needs A&E the same day, not a scheduled clinic visit.
Warning signs that may point to a gallbladder problem
- Upper right or middle abdominal pain, particularly after meals
- Pain that spreads to the right shoulder or upper back
- Nausea or vomiting during pain episodes
- Persistent bloating or indigestion after fatty foods
- Yellowing of the skin or the whites of the eyes, known as jaundice
- Dark urine or pale stools
A gallstone attack can feel alarming. The pain typically peaks within an hour and may last several hours before subsiding. Between attacks, many people feel completely well, which makes it easy to delay seeking medical attention.
If the pain is accompanied by fever, chills, or yellowing of the skin or eyes, go to A&E immediately. These symptoms suggest the stone may have caused a blockage or infection requiring prompt assessment, not a scheduled clinic visit.
If the pain is severe, constant, and accompanied by fever, the gallbladder may be acutely inflamed. Unlike a typical gallstone attack, this pain does not ease within a few hours. Go to A&E, or contact Dr Sulaiman’s clinic directly. Acute cholecystitis typically requires surgery, sometimes on an urgent basis.
Gallstones cannot be dissolved or eliminated with medication alone. Dietary changes may help manage symptoms in the short term, but they will not remove existing stones or prevent further attacks. For patients experiencing symptoms from gallstones, surgery is the only definitive treatment.
What each symptom may mean, and what to do about it
| Symptom | What it could mean | What to do |
|---|---|---|
| Upper right abdominal pain after meals | Gallstone attack | Book a consultation |
| Pain radiating to the right shoulder or back | Gallstone pressing on surrounding structures | Book a consultation |
| Nausea or vomiting | Gallbladder inflammation | Book a consultation |
| Fever with abdominal pain | Possible infection, acute cholecystitis | Go to A&E |
| Yellowing of skin or eyes | Bile duct blockage | Go to A&E immediately |
| Dark urine or pale stools | Bile duct blockage | Go to A&E immediately |
| Persistent bloating after fatty meals | Gallbladder dysfunction | Book a consultation |
What it is
Removing the gallbladder, through cuts about a centimetre wide.
Laparoscopic gallbladder removal, or laparoscopic cholecystectomy, is a minimally invasive surgical procedure that removes the gallbladder.
The gallbladder is a small organ under the liver that stores bile, a digestive fluid produced by the liver. This procedure is typically performed to treat gallbladder issues such as gallstones, inflammation, or infections that cause pain and digestive problems. The primary goals are to relieve pain and prevent further complications.
Who needs a laparoscopic gallbladder removal
Laparoscopic gallbladder removal is typically performed when gallbladder problems cannot be treated with medication or other methods. The most common reasons for this procedure are the following four.
Gallstones
Solid particles that form in the gallbladder and can block bile flow, causing pain, infection, or inflammation. Gallstones are the most common reason for laparoscopic gallbladder removal in Singapore.
Acute cholecystitis
Inflammation of the gallbladder caused by a stone blocking the cystic duct, resulting in persistent pain and infection. Untreated, this carries a risk of rupture and requires surgical removal of the gallbladder.
Biliary dyskinesia
A condition in which the gallbladder contracts abnormally, causing pain and digestive symptoms even when no stones are present. It is typically diagnosed through a HIDA scan.
Gallbladder polyps
Growths on the inner wall of the gallbladder. Polyps larger than 10mm, or those that are symptomatic or increasing in size, may require gallbladder removal to exclude the possibility of malignancy.
Keyhole or open
The same organ comes out. The difference is what it costs you in time.
Laparoscopic gallbladder removal offers several advantages over open cholecystectomy. These are the key differences.
| Comparison | Laparoscopic | Open surgery |
|---|---|---|
| Incision size | 3 to 4 cuts, each less than 1cm | Single incision of 5 to 7cm |
| Hospital stay | Day surgery or 1 night | 2 to 5 nights |
| Recovery time | 1 to 2 weeks | 4 to 6 weeks |
| Return to desk work | 5 to 7 days | 3 to 4 weeks |
| Pain level | Mild, usually managed with paracetamol | Moderate to significant |
| Scarring | Minimal | More prominent |
How long before desk work, keyhole against open surgery
- Keyhole
- 5 to 7 days
- Open surgery
- 3 to 4 weeks
Source: Dr Sulaiman Bin Yusof, clinical practice
Ten marks stand for four weeks. The figures beside each row are the exact ones, and the marks are there to show the size of the gap rather than to be counted.
A shorter recovery, and an earlier discharge
The shorter recovery period allows patients to resume normal activities, such as work and exercise, significantly sooner than with open surgery. Many patients are discharged the same day or after a single overnight stay in hospital.
Smaller incisions and less tissue damage
The 3 to 4 incisions used in laparoscopic surgery are each less than 1cm in length, compared to the 5 to 7cm incision required for open cholecystectomy. This results in less tissue damage and considerably smaller scars.
Pain that ordinary painkillers usually cover
Most patients manage discomfort after laparoscopic gallbladder surgery with over-the-counter pain relief such as paracetamol or ibuprofen. Stronger prescription analgesia is available if required.
Scope and gallbladder surgery, one specialist, one visit
Dr Sulaiman can perform a gastroscopy in the same operating session as laparoscopic gallbladder surgery.
If you also have persistent acid reflux, chronic indigestion or a suspected peptic ulcer, both can be dealt with in the same session under one anaesthetic, which means one hospital admission instead of two. That comes out of his years as Director of Endoscopy at Changi General Hospital, where colonoscopy screening and gastroscopy were daily work.
He also performs colorectal cancer surgery, treats anal fistula and perianal abscess, and repairs hernias laparoscopically. More about Dr Sulaiman.
Preparing
Most of the preparation happens at the consultation, not on the day.
Proper preparation is necessary prior to laparoscopic gallbladder removal to ensure a successful operation, and it covers four things.
Tell Dr Sulaiman about every medication you take, including blood thinners, diabetes medication and over-the-counter supplements, at your pre-operative consultation.
Medical evaluation: ultrasound, blood tests and imaging
Before laparoscopic gallbladder removal, Dr Sulaiman will request an abdominal ultrasound and blood tests. Where needed, a CT scan or MRI may also be arranged to confirm the diagnosis and assess for stones in the bile duct. This evaluation is carried out at your pre-operative consultation.
Fasting requirements before your operation
Patients are usually required to fast before surgery, beginning the night before and abstaining from all food and drink to ensure an empty stomach for the procedure.
Medication adjustment: blood thinners, diabetes and supplements
Patients taking warfarin, aspirin, or diabetes medications such as insulin should inform Dr Sulaiman at their pre-operative consultation so that adjustments can be planned safely. Certain supplements, including fish oil, vitamin E, and garlic tablets, may also need to be paused before surgery, as they can increase the risk of bleeding.
What to arrange on the day of surgery
Arrange for a family member or friend to drive you home, because you will not be cleared to drive on the day of your operation. Wear loose, comfortable clothing and leave jewellery and valuables at home. Bring your pre-admission documents, any letters of guarantee from your insurer, and a written list of your current medications. Report to the day surgery suite at your assigned arrival time.
On the day
What actually happens once you are in theatre.
A laparoscopic gallbladder removal involves several steps, and they run in the same order every time.
Anaesthesia
Asleep, with vital signs watched throughout
The incisions
Three or four, each under a centimetre
Camera and instruments
Trocars, then the laparoscope
The gallbladder is freed
Cystic duct and artery clipped and cut
It comes out in a bag
Drawn through one of the small incisions
Closed and dressed
Home the same day, or after one night
General anaesthesia
Administration of general anaesthesia ensures that the patient is asleep and pain-free throughout the surgery. The surgeon monitors the patient's vital signs and adjusts the anaesthesia as needed.
Making the keyhole incisions, 3 to 4 small cuts
Dr Sulaiman makes 3 to 4 incisions in the abdominal wall, each less than 1cm in length. Open cholecystectomy, by comparison, typically requires a single incision of 5 to 7cm. These small incisions serve as entry points for the laparoscopic instruments and camera, and result in significantly less tissue damage to the surrounding area.
Insertion of the trocars and the laparoscope
Trocars are hollow tubes that are inserted through the incisions. A laparoscope, a thin tube containing a light and a camera, is inserted through one of the trocars. The camera provides a high-definition view of the abdomen on a monitor, guiding the surgeon throughout.
Identification and safe detachment of the gallbladder
The surgeon identifies the gallbladder and its associated structures, such as the cystic duct and cystic artery. Using specialised instruments, the surgeon carefully clips and cuts the cystic duct and artery, disconnecting the gallbladder from the liver and its blood supply.
Removal of the gallbladder
The gallbladder is carefully isolated and placed in a small bag for extraction. It is removed through one of the small incisions and may be broken into smaller pieces for easier removal.
Closing the incisions, and discharge
After the gallbladder is removed, the carbon dioxide gas is released from the abdomen. The incisions are closed with sutures or surgical staples, and sterile dressings are applied to each site. The entire laparoscopic gallbladder removal typically takes 45 to 90 minutes. Most patients are discharged the same day or after one overnight stay.
Recovery and diet
Desk work in a week, ordinary food in about a month.
Proper care after a laparoscopic gallbladder removal ensures a smooth recovery. Most patients return to desk work within five to seven days and resume normal activities within one to two weeks of surgery.
First 24 to 48 hours: immediate post-operative care
You will be monitored in a recovery area until you are fully awake and your vital signs are stable. Mild discomfort and referred pain in the right shoulder or upper back from the carbon dioxide gas used during surgery are common, and this typically resolves within 24 to 48 hours. Pain is managed with medication, and most patients require only over-the-counter pain relief such as paracetamol or ibuprofen during recovery. Most patients go home the same day.
Week 1 to 2: returning to light activities
Plan to rest for the first two to three days after surgery. Short, gentle walks from day one are encouraged and help reduce the risk of blood clots. Avoid lifting anything heavier than 5kg and refrain from strenuous activity for the first week. Driving is not recommended until you are off all prescription pain medication and can react normally, which for most patients is around five to seven days after surgery.
Week 4 to 6: resuming normal life
By weeks four to six, most patients have returned to their full range of daily activities, including light exercise such as brisk walking and swimming. Return to physically demanding work or contact sport depends on the nature of the activity. Dr Sulaiman will advise on a specific timeline at your post-operative review.
Diet after gallbladder removal: what you can and cannot eat
After laparoscopic gallbladder removal, bile flows directly from the liver into the small intestine rather than being stored between meals, which is what makes fatty food harder to handle at first.
Foods to favour in the first two weeks
- Steamed or boiled rice, congee, or plain noodles
- Lean proteins: chicken breast, fish, tofu
- Steamed or boiled vegetables
- Low-fat dairy products
Foods to avoid in the first two weeks
- Fried or greasy foods, including roti prata, nasi lemak and char kway teow
- High-fat cuts of meat and heavy gravies
- Spicy food
- Cream-based dishes and sauces
Some patients experience temporary loose stools or bloating as the digestive system adjusts. This usually settles within four to six weeks.
Warning signs: when to contact Dr Sulaiman after surgery
Contact Dr Sulaiman’s clinic immediately if you experience any of the following after your laparoscopic gallbladder surgery.
- Fever above 38°C
- Yellowing of the skin or eyes, known as jaundice
- Severe abdominal pain that is worsening rather than improving
- Green or brown discharge from an incision site
- Inability to keep fluids down
These symptoms may indicate bile leakage, wound infection, or another complication requiring prompt assessment.
A fever above 38°C, worsening abdominal pain, or yellowing of the skin or eyes after surgery needs to be assessed the same day.
Cost and insurance
What it costs, and what pays for it.
Nobody can quote this operation to the dollar in advance, because the number moves with how difficult the gallbladder turns out to be and how long you stay. Dr Sulaiman's clinic gives you a personalised estimate at your pre-operative consultation.
What a gallbladder removal is billed at
- Median bill, private hospital inpatientHalf of patients were billed below this and half above.
- $21,157
- The middle half of bills
- $19,363 to $23,802
Figures include GST, before insurance and MediSave. The code MOH reports under covers both keyhole and open removal together, so this is the figure for the operation rather than for the keyhole approach specifically. What you pay depends on the hospital, the ward and what your insurance covers, which is set out below.
MediSave
Laparoscopic gallbladder removal is a MediSave-claimable procedure (source: CPF Board, using MediSave for hospitalisation, opens in a new tab) for eligible Singaporeans and Permanent Residents. Withdrawal limits vary depending on procedure complexity and the applicable TOSP code, and Dr Sulaiman's clinic staff will advise on the limits that apply to you at your pre-operative consultation.
Integrated Shield Plans
Most Integrated Shield Plans cover laparoscopic gallbladder removal when the procedure is medically necessary. Dr Sulaiman's team arranges pre-authorisation and cashless billing with your insurer before your surgery date. No upfront deposit is typically required once a Letter of Guarantee is obtained.
Corporate insurance and panel insurers
Corporate policies are accepted alongside the two above. Panel insurers include AIA, Prudential, Great Eastern, Singlife and NTUC Income.
Common questions
The questions that come up before gallbladder surgery.
Who performs the surgery, and where?
Dr Sulaiman Bin Yusof is a Senior Consultant colorectal and general surgeon offering laparoscopic, or keyhole, gallbladder removal at five private clinic locations across Singapore. Self-referrals are accepted, and same-week consultation appointments are typically available.
How long is the recovery after gallbladder removal?
Most patients return to desk work within five to seven days and resume normal activities within one to two weeks of laparoscopic gallbladder surgery. Strenuous physical activity and heavy lifting are typically restricted for two to four weeks. A normal diet is usually possible within four to six weeks.
Can a gastroscopy be done at the same time as my gallbladder surgery?
Yes. Dr Sulaiman can combine a diagnostic gastroscopy with laparoscopic gallbladder surgery in the same operating session. This is relevant for patients with concurrent upper GI symptoms such as acid reflux, persistent indigestion, or suspected peptic ulcers. Combining procedures in a single session reduces the total number of anaesthetic events required.
Is this claimable under MediSave or insurance?
Yes. Laparoscopic gallbladder removal is MediSave-claimable for eligible Singaporeans and Permanent Residents. Most Integrated Shield Plans and corporate insurance policies also cover the procedure when it is medically indicated. Dr Sulaiman's team coordinates pre-authorisation and cashless billing with your insurer before your surgery date.
What can I eat after the gallbladder is removed?
Avoid fatty, fried, and greasy foods for the first one to two weeks. Begin with small, light meals and gradually reintroduce your normal diet. A full normal diet is typically possible within four to six weeks. Some temporary changes in digestion, such as loose stools or bloating, are common and usually resolve as the body adjusts.
How do I know whether keyhole surgery is right for me?
Consult your surgeon to discuss your symptoms, medical history, and treatment options. They will help determine if laparoscopic gallbladder removal is the most appropriate approach for your condition.
Can gallstones come back after the gallbladder is removed?
Gallstones cannot recur in the gallbladder once it is removed. However, stones may still form in the bile ducts, though this is uncommon. Maintaining a healthy diet and weight can help reduce this risk.
Can I live normally without a gallbladder?
Without a gallbladder, bile flows directly from the liver into the small intestine, which can affect digestion. Some patients may experience temporary changes such as diarrhoea, bloating, or gas, but these usually improve as the body adjusts.
Book a consultation
Gallstones will not dissolve on their own. Have them assessed.
If you have gallstones, recurring gallbladder pain, or have been told you need your gallbladder removed, consult Dr Sulaiman for an assessment and a personalised surgical plan. Clinics are open Monday to Friday, 9.00am to 6.00pm, and Saturday, 9.00am to 1.00pm, with Sunday and public holiday appointments available on request. Self-referrals are accepted, GP referrals are welcome, MediSave and most insurance plans are accepted, and same-week consultations are typically available.