Diagnosis Information:
Hepatobiliary/Gallbladder

Hepatobiliary surgery encompasses disorders of the liver, bile ducts, and gallbladder. Surgeons at Brigham & Women's Hospital are among the world's leaders in hepatobiliary surgery. Particular strengths include the treatment of gallstones, biliary strictures, bile duct cancer, and liver cancers. During the past decade our surgeons pioneered the use of laparoscopic techniques in treating hepatobiliary diseases. Today they are pioneering the use of robotic and other minimally-invasive technologies in making these procedures safer.

Gallbladder disorders range from common and easily treated conditions, such as gallstones, to rare and difficult to treat ones, such as gallbladder cancer.

Gallstones 
Located under the liver, the gallbladder's function is to store bile that is secreted by the liver. Following meal ingestion, this stored bile is released into the intestine, facilitating digestion. Abnormalities of bile composition can lead to the formation of gallstones. Anyone can develop gallstones, but known risk factors include female gender, obesity, and age. Most gallstones cause no symptoms and do not necessarily need treatment. However, patients who have gallstone-related symptoms should be evaluated by a surgeon.

Gallstone-related Symptoms The most common symptom of gallstones is pain in the upper abdomen or under the right-side of the rib cage, usually occurring an hour or two after eating. The duration of the pain is typically one to several hours. Nausea and vomiting often occur during this period. These episodes of pain resolve spontaneously and are known as biliary colic.

If the pain does not resolve after several hours, then a more serious condition known as acute cholecystitis may be present. In this condition, the gallbladder becomes inflammed. Right-sided abdominal pain is persistent, severe, and usually accompanied be a fever. This condition is an emergency and requires hospitalization, intravenous antibiotics, and possibly urgent surgery.

Common Bile Duct Stones 
In most patients with gallstones, the stones are confined to the gallbladder. In some patients, however, they are present in the common bile duct, the conduit that allows bile to be transported from the gallbladder to the intestine. Although common bile duct stones can be asymptomatic, they can cause severe problems, including jaundice (yellowness of the skin and eyes) and cholangitis (infection of the bile).