Gallbladder & Bile Duct Conditions

Your gallbladder is a pear-shaped organ located under your liver. It stores bile, a fluid made by your liver to digest fat. As your stomach and intestines digest food, your gallbladder pushes the bile into tubes called bile ducts. They carry the bile to your small intestine to break down fat and get rid of wastes in the body.

At El Camino Health, doctors are fellowship trained in digestive disorders. They use the best available diagnostic equipment to determine the cause of your symptoms and create an effective treatment plan.

The large number of procedures we perform — most are minimally invasive — allows us to enhance our skill and lower complication rates so you can return to normal activities more quickly.

Throughout your treatment, our doctors and other members of the digestive team will do everything possible to answer your questions and make you feel at ease. Our focus is always on helping you feel better.

An Oncology coordinator helps coordinate your care, provides answers and schedules appointments for you. Our gastroenterologists work closely with other specialists, as needed, to offer you comprehensive care.

We treat a variety of gallbladder and bile duct conditions.

Gallstones (Bile Duct Stones)

Gallstones — small, hard masses that crystallize from stored bile in the gallbladder, also called bile duct stones — are one of the most common causes of blocked bile ducts and gallbladder inflammation (cholecystitis). Other causes include a tumor or scar tissue.

Stones can pass on their own through the bile ducts, but if they become stuck, they can cause inflammation and infection. Symptoms of bile duct blockage include severe abdominal pain, fever, jaundice (yellowish skin), nausea and vomiting.

We use minimally invasive endoscopic retrograde cholangiopancreatography (ERCP) to guide special tools through an endoscope to remove the stones.

Cholecystitis (Inflamed Gallbladder)

If bile becomes trapped in your gallbladder, it can lead to swelling and infection — called cholecystitis — which can occur suddenly or become chronic. Cholecystitis most commonly occurs if a gallstone is blocking the bile duct that delivers bile from the gallbladder to the small intestine. Occasionally, infection occurs because the gallbladder’s normal contracting motion to push out stored bile isn’t working properly.

Symptoms of cholecystitis include:

• Steady pain (can be sharp or dull) in the upper right side or upper middle of your abdomen that usually lasts at least 30 minutes.
• Pain that spreads to your back or below your right shoulder blade.
• Flu-like symptoms such as diarrhea, fever, nausea and vomiting.
• Yellowing of skin and whites of the eyes (jaundice).
• Severe bloating.

Seek medical attention if you have severe belly pain that doesn’t go away.

Our digestive specialists use blood tests and imaging techniques such as abdominal ultrasound, MRI and ERCP to identify the cause of inflammation. ERCP, which uses an endoscope, dye and X-rays to view the gallbladder area, has the added advantage of allowing your doctor to remove a gallstone during the procedure.

Another test, cholescintigraphy (also called HIDA scan), injects a small, safe amount of radioactive material into the gallbladder to make it contract. This test allows doctors to measure abnormal contraction of the gallbladder or obstruction of the bile ducts.

Antibiotics and pain medications can help relieve symptoms, but if they persist and gallstones continue to cause problems, surgeons at El Camino Health can remove the gallbladder. In most cases, doctors can use minimally invasive laparoscopic surgery with small incisions. Occasionally, a larger incision is required to perform the operation.

Dietary Suggestions Following Gallbladder Removal

Following gallbladder removal, bile gets released directly into the small intestines. This can cause loose stools for a time. Dietary changes that may minimize this effect are:

• Avoid high-fat foods.
• Increase dietary fiber.
• Eat smaller meals more frequently to absorb the bile.
  • Limit foods that tend to promote diarrhea, such as caffeine, dairy products, and greasy or very sweet foods.

Bile Duct Infection (Cholangitis)

Bile duct infection — also called cholangitis — is an infection of the common bile duct, the tube that carries bile from the gallbladder to the small intestine.

A bacterial infection may occur if the duct becomes blocked by a gallstone or tumor. If left untreated, it can spread to the liver. You may experience pain, fever, chills, dark urine, jaundice (yellowing of the skin), nausea and vomiting.

El Camino Health’s gastrointestinal specialists use antibiotics as a first line of treatment. If the infection has progressed, they can perform ERCP or a surgical procedure to clean out the infected tissue and reduce inflammation.

Bile Duct Leaks

A small hole anywhere in your bile duct system can cause leakage of bile into your abdominal cavity, which can lead to infection and inflammation. Symptoms include severe abdominal pain, fever, jaundice, nausea and vomiting.

Holes can occur from trauma (physical injury) or from complications of abdominal surgery. At El Camino Health, we use ERCP to reach the area of the hole with a scope and to place a temporary bile duct stent (a tiny, flexible tube) to cover the hole until it heals.

Bile Duct and Gallbladder Cancers

Cancers of the bile duct and the gallbladder are rare.

According to the American Cancer Society, 2,000 to 3,000 cases of bile duct cancer are diagnosed in the U.S. each year. Symptoms of bile duct cancer include jaundice (yellowish skin), itchy skin, fever, abdominal pain and weight loss.

Gallbladder cancer isn’t usually found until it spreads beyond the gallbladder. According to the American Cancer Society, about 4,000 new cases are diagnosed each year. Symptoms generally don’t appear in the early stages of gallbladder cancer. In later stages, they may include jaundice, abdominal pain, fever, nausea, vomiting and bloating.

At El Camino Health, we offer a full range of advanced treatments to treat bile duct and gallbladder cancers.