Liver & Biliary Diseases

Gallbladder Disease

Gallstones and cholecystitis (inflammation of the gallbladder) are two of the most common diseases that effect the gallbladder. You may have pain, bloating, food intolerance, and other discomfort that interferes with your ability to enjoy life fully. At NewYork-Presbyterian, our gallbladder specialists have noted expertise in assessing and treating gallstones and cholecystitis, offering nonsurgical and surgical approaches to relieve your pain and restore your quality of life. Our teams include interventional endoscopists who use innovative methods to diagnose and treat gallbladder disease without surgery, using treatments not widely available elsewhere.

Your Treatment Team

Your healthcare team includes gastroenterologists, interventional endoscopists, surgeons, nurses, physician assistants, registered dietitians, and others with experience caring for people with gallbladder disease. They collaborate to provide the most effective therapy for you. In addition to gallstones and cholecystitis, our team treats other gallbladder disorders, such as biliary colic, gallstone pancreatitis, and cholangitis.

Cirrhosis, biliary tract infections, sickle cell or other hemolytic anemia, and cystic fibrosis increase the risk of pigment stones. If you have any of these diseases, we have specialists in these areas as well so you can receive all the care you need at one medical center.

Advanced Diagnostic Testing for Gallbladder Disease

Our gastrointestinal team will perform a number of tests to determine if you have gallstones or gallbladder inflammation, including:

• Abdominal ultrasound. This test uses sound waves to visualize your abdominal organs.
• Imaging tests. CT scanning and magnetic resonance imaging (MRI).
• Magnetic resonance cholangiopancreatography (MRCP). MRI is used to produce detailed cross-sectional images of your digestive organs and tissues.
• Endoscopic ultrasound (EUS). An interventional endoscopist uses a special endoscope with high-energy sound waves ("echoendoscope") to see your digestive tract and nearby organs and to determine if you have gallstones.
• Endoscopic retrograde cholangiopancreatography (ERCP). This technique combines endoscopy and x-ray. An interventional endoscopist guides an endoscope through your mouth to the gallbladder and bile ducts, releases a dye that assists in imaging the ducts, and then x-rays them. ERCP provides a clear image of the structure of your gallbladder and bile ducts and can show any abnormalities. NewYork-Presbyterian’s interventional endoscopists routinely perform this procedure and are highly regarded experts in its use.

Comprehensive Treatment for Gallbladder Disease

Gallstones and gallbladder inflammation may be treated in a number of ways, depending on your age, overall health, and the extent of the problem. Your doctor will discuss which method is most appropriate for you.

• Medication. If you have pain from acute cholecystitis, you may be admitted to the hospital to receive intravenous fluids and antibiotics to reduce inflammation, fight any infection present, and relieve pain.
• Endoscopic retrograde cholangiopancreatography. Doctors can use ERCP in combination with other techniques to remove stones, particularly those in the common bile duct.
• Choledochoscopy and pancreatoscopy. An interventional endoscopist inserts an endoscope into the common bile duct (choledochoscopy) or pancreatic duct (pancreatoscopy) to remove gallstones using a laser or electrohydraulic lithotripsy (shock wave therapy).
• Cholecystectomy. A treatment for gallstones or cholecystitis, your surgeon removes the gallbladder and restructures your biliary system so that bile flows directly from your liver into the small intestine. This procedure is usually performed laparoscopically, using smaller incisions than conventional surgery and resulting in less pain after surgery and a quicker recovery.
• Gallbladder drainage. If you have an acutely enlarged gallbladder and infection and cannot have surgery, the gallbladder may be emptied externally by placing a small tube through the skin or internally by placing a special stent from the stomach or small intestine.