Does having retroartic left renal vein usually mean you have nutcracker syndrome, especially when you have many symptoms? or can you have rlrv without ncs? also does having abdominal surgery i.e gallbladder surgery affect rlrv?

Retroartic left renal vein is rare, but means the left renal vein lies behind the aorta, which compresses the left renal vein leading to backup, higher venous pressure, and can cause frequent bloody urine, and "nutcracker syndrome" which is a description of increased aortic compression of the renal vein, much like a blood pressure cuff when measuring blood pressure.

Nutcracker syndrome symptoms vary and depend on the degree of RV obstruction. Some have the symptoms and some don't. Surgeries you mention do not affect it.