When you are living with lupus, the idea of undergoing a procedure — even something routine like gallbladder surgery — can be scary. Your mind might race with questions: “Why do I need surgery? How should I prepare? What are the risks?”

Members of MyLupusTeam have raised their questions and concerns. One member asked, “Have any of you had to get surgery to get your gallbladder removed?”

Gallbladder removal, also called cholecystectomy, is a common general surgery that is sometimes done to address gallbladder disease. If you have lupus (also called systemic lupus erythematosus or SLE) and are facing gallbladder surgery, these five facts might help answer some of your questions.

1. Lupus May Affect the Gallbladder

The gallbladder, a small organ in the upper right quadrant (quarter) of your abdomen, stores and excretes bile (a substance that breaks down fatty foods). However, the gallbladder is prone to developing stones, inflammation, and infection, and is often removed in people with and without lupus.

One member explained their history of gallbladder disease and lupus: “Over many years, my gallbladder would give me severe pain, but they couldn’t find stones. Eventually, my gallbladder became infected and had to be removed. After I was diagnosed with lupus, my doctors believed my problems were autoimmune all along.”

Lupus has rarely been found to cause inflammation in the gallbladder, sometimes without any gallstones, due to an attack by the body’s misguided immune system. This condition is called acute acalculous cholecystitis, which causes abdominal pain and vomiting and can be one of the first signs of SLE. The exact mechanisms linking lupus and gallbladder problems are not fully understood but may be related to the autoimmune characteristics of lupus. More research is needed to understand the effects of lupus and its treatment on the gastrointestinal system, including the gallbladder.

2. Severe Gallbladder Problems May Require Surgery

Gallbladder problems, such as gallstones or inflammation, cause symptoms such as:

• Pain in the upper right abdominal area, below the rib cage
• Nausea, vomiting, or diarrhea
• Indigestion

If you experience these symptoms, consult with your health care provider for an accurate diagnosis. During the physical examination, your doctor will assess your level of pain and ask questions about your medical history. Imaging tests may include ultrasound and CT scans. Laboratory tests may include a complete blood cell count to check your levels of white blood cells (a sign of inflammation) and your platelet count, as well as a blood test to look for bilirubin. The presence of this yellowish substance, which is in bile, may indicate a blockage in your biliary tract (the gallbladder and bile ducts).

Cholecystectomy is typically recommended for severe symptoms or complications related to gallbladder problems, such as repeated gallstone attacks, infection, or blocked bile ducts. Your health care provider will determine if surgery is the most appropriate treatment option for you.

3. Most Gallbladder Surgery Is Minimally Invasive

If you’ve been told that you need gallbladder surgery, be sure to let your surgeon know about your lupus right away. It’s also important to tell your rheumatologist about your gallbladder disease and need for surgery, as you may have complications if your disease activity is not under control or if some lupus treatments may be interrupted for a while. Together, your health care team will consider the potential impact of lupus on gallbladder surgery to ensure that the procedure is safe for you.

The most common type of gallbladder surgery is laparoscopic cholecystectomy, which is also the least invasive. Four small incisions allow the surgeon to insert a small video camera and special tools so they can see inside your abdomen and remove the gallbladder. Many people can have the surgery and return home the same day.

An open cholecystectomy is more invasive, requiring one 6-inch incision in the abdomen. The longer incision means a longer hospital stay, usually two or three days.

When preparing for your procedure, follow your surgeon’s instructions closely. For example, they will probably ask you to not eat the night before so that you go into surgery on an empty stomach. They’ll also let you know if you should continue using your lupus treatments as prescribed or stop taking certain medications, such as steroids like prednisone.

Even if you undergo a laparoscopy, it’s wise to pack toiletries and a change of clothes in case you develop complications and are hospitalized. You’ll also need to make arrangements for someone to drive you home and stay with you overnight.

4. Your Surgical Team Will Consider Lupus-Related Risks

Like any surgical procedure, gallbladder surgery comes with certain risks, including:

• Bleeding
• Infection
• Injury to nearby body structures
• Side effects of general anesthesia, such as blood clots

Having lupus brings additional considerations regarding procedures like gallbladder surgery. For example, autoimmune diseases like lupus raise the risk of antiphospholipid syndrome. This condition develops when the immune system mistakenly makes antibodies that increase the likelihood of blood clotting.

It’s crucial to talk with your health care provider about the surgery’s potential risks and benefits, taking into account your lupus and overall health status, including other autoimmune conditions, such as Sjӧgren’s syndrome (a long-lasting autoimmune condition that causes dryness in the eyes and mouth). Make sure your surgeon, anesthesiologist, and nurses are aware of your lupus and any other conditions, all medications and supplements you take, and any known sensitivities.

5. You Could Have a Lupus Flare After Gallbladder Surgery

Proper postoperative care will help you make a smooth recovery. After gallbladder surgery, your plan will focus on:

• Managing pain
• Slowly reintroducing a regular diet
• Taking medications as prescribed

People with lupus may need additional support during recovery. For example, surgery’s stress on the body and potential changes in medication can trigger lupus flares. Make sure to closely monitor your symptoms and report any significant changes to your health care provider to ensure a full recovery after gallbladder surgery.

Never hesitate to ask your medical team questions about your care. “Ask good questions, and make sure you understand what they are suggesting you do for this condition,” one MyLupusTeam member advised. “Ask about downtime, pain control, and long-term expectations from surgery.” Getting gallbladder surgery on top of living with lupus may seem overwhelming, but your health care team is there to help you every step of the way.

Talk With Others Who Understand

MyLupusTeam is the social network for people with lupus and their loved ones. On MyLupusTeam, more than 223,000 members come together to ask questions, give advice, and share their stories with others who understand life with lupus.

Have you needed gallbladder surgery since your lupus diagnosis? What advice can you offer others who are facing surgery? Share your experience in the comments below, or start a conversation by posting on your Activities page.