The removal of the gallbladder is followed by a number of compensatory changes, which in most cases do not result in clinical symptoms: the loss of the pressure reservoir for the bile, the duodenogastric reflux with a subsequent increase in gastric pH and helicobacter infections as well as alterations in bile metabolism. An increased incidence of colon carcinoma has been suggested to be caused by cholecystectomy. However, this might also be due to cholelithiasis. Abdominal symptoms widely regarded as postcholecystectomy syndrome are often due to functional disorders of the gastrointestinal tract and the unrelated to the loss of the gallbladder. Therefore, the expression postcholecystectomy syndrome is imprecise and should not be used in the future. Changes affecting the bile ducts such as sphincter Oddi dyskinesia, stones and stenoses are rare and treatment by endoscopic interventions is generally successful.