Gallbladder Disease

The gallbladder is a small, hollow organ located under the liver. Your liver produces bile, a substance that helps break down fats. Bile leaves the liver through vessels called bile ducts and enters the gallbladder, where it is stored until your body needs it for digestion.

If a bile duct becomes blocked, it can lead to inflammation and other problems with the gallbladder. Less frequently, cancer can occur within the gallbladder or bile ducts.

Because symptoms of gallbladder and bile duct disorders may mimic other gastrointestinal problems, it’s important to find a specialist who is trained to pinpoint the exact cause of your symptoms and provide timely treatment.

Scripps gastroenterologists have extensive experience diagnosing and treating medical problems that affect the gallbladder and bile ducts, including:

• Cholecystitis is the formal name for gallbladder inflammation. It can come on suddenly (acute cholecystitis) or occur repeatedly over a long period of time (chronic cholecystitis). It usually occurs after a bile duct becomes blocked, causing bile to build up inside the gallbladder.

• Gallstones are hard, stone-like masses that form inside the gallbladder or bile ducts. While some gallstones are no larger than a grain of sand and cause few if any problems, they can grow large enough to block a bile duct.

• Cholangitis, an infection in a tube called the common bile duct, which carries bile from the liver to the gallbladder.

• Bile duct cancer, or cholangiocarcinoma, is a rare form of cancer that occurs in one of the bile ducts. While it is a slow-growing cancer, it is often not diagnosed until it is at an advanced stage.

• Gallbladder cancer is a rare form of cancer that begins in the gallbladder. Because it causes few symptoms early on, it is often not diagnosed until it is at an advanced stage.

Scripps doctors use a variety of tests and procedures to diagnose gallbladder disease, including one or more of the following:

• Hepatobiliary iminodiacetic acid (HIDA) scan is an imaging procedure that takes pictures of your liver, gallbladder, bile ducts and small intestine. During the exam, a harmless radioactive solution is injected into a vein in your arm. Special cameras monitor the flow of this solution as it makes its way from your liver to your gallbladder and into your small intestine.

• Endoscopic retrograde cholangiopancreatography, or ERCP, is an endoscopic procedure that allows doctors to examine the bile ducts. It is often used to diagnose bile duct cancer, gallbladder cancer and gallstones.

• Endoscopy, a procedure that allows doctors to look inside your body with the aid of a tiny camera attached to a thin, flexible tube called an endoscope. Small instruments or devices can be attached to the endoscope, allowing it to be used for both diagnosis (such as taking a tissue sample during a biopsy) and treatment (for example, to remove tumors).

• Endoscopic ultrasound, or EUS, combines endoscopy and ultrasound to capture high quality images of the digestive tract.

• Laparoscopy is a minimally-invasive surgical procedure that allows doctors to examine an organ, such as the gallbladder, up close.

Scripps offers numerous medical and surgical treatment options for gallbladder disease, including:

• Cholecystectomy, a surgical procedure to remove the gallbladder. The surgery can be performed using either traditional (“open”) or minimally-invasive techniques.
• Liver transplant is a surgical procedure in which a diseased liver is replaced with a healthy donor liver. Liver transplant is sometimes an option for people with bile duct cancer, especially if their affected bile duct is located within the liver or at the junction where the bile duct exits the liver. Learn more about liver transplantation at Scripps.
• Biliary bypass is a surgical procedure that may be used to treat gallbladder or bile duct cancer, particularly if a tumor is blocking the small intestine (causing bile to build up within the gallbladder). During the procedure, a surgeon creates a detour, or “bypass,” around the blockage, which reroutes the bile so it can flow into the small intestine.
• If you have gallbladder cancer or bile duct cancer, your gastroenterologist will work closely with Scripps cancer specialists to create a customized treatment plan. Learn more about gallbladder and bile duct cancer treatment at Scripps.

Scripps gastroenterologists offer consultations or care for people with gallbladder disease at the following locations:

• Scripps Memorial Hospital Encinitas
• Scripps Memorial Hospital La Jolla
• Scripps Mercy Hospital (San Diego and Chula Vista)
• Scripps Green Hospital
• Scripps Clinic Carmel Valley
• Scripps Clinic Encinitas
• Scripps Clinic Rancho Bernardo
• Scripps Clinic Rancho San Diego