Gallbladder & Bile Ducts

The gallbladder stores bile, while the bile ducts are the small tubes that carry it from the liver to the intestine. Conditions in this area range from common benign problems such as gallstones to strictures, cysts, and tumors that need specialist investigation. Assessment combines symptoms, blood tests, and the right imaging study.

Gallstones and biliary colic

What happens: Gallstones are solid particles that form in the gallbladder. Many people never develop symptoms. When a stone temporarily blocks the flow of bile, it can cause a painful episode called biliary colic.

Risk factors: Age, pregnancy, higher body weight, rapid weight loss, diabetes, some medicines, and family history can increase the likelihood of gallstones.

Symptoms: Pain in the upper right abdomen or upper middle abdomen, often after food, sometimes with nausea or vomiting. Fever, persistent pain, jaundice, dark urine, or pale stools need urgent medical assessment.

Diagnosis and treatment: Ultrasound is usually the first test. When stones cause repeated symptoms or complications, keyhole removal of the gallbladder is often the definitive treatment.

Acute cholecystitis

What happens: Acute cholecystitis is inflammation of the gallbladder, most often because a stone blocks the cystic duct. Pain commonly persists and may be associated with fever and abdominal tenderness.

Assessment: Clinical examination, blood tests, and ultrasound are central. CT or other imaging may be needed in selected situations.

Treatment: Hospital treatment may include fluids, pain relief, and antibiotics where indicated. The timing of surgery is individualized according to the severity of the episode, overall health, and imaging findings.

Common bile duct stones and cholangitis

A stone can move from the gallbladder into the main bile duct. This may cause obstruction, jaundice, or pancreatitis. When the bile ducts become infected, cholangitis is an emergency: fever or chills together with jaundice and pain require urgent assessment.

Liver blood tests, ultrasound, MRCP, CT, and endoscopic ultrasound are chosen according to the situation. ERCP can remove a stone or drain the bile duct when there is an obstruction.

Gallbladder polyps

Polyps are small growths on the inner surface of the gallbladder and are often found incidentally. Most are benign. Their size, shape, change over time, symptoms, and individual risk factors guide the decision between surveillance and gallbladder removal.

Bile duct strictures, cysts, and tumors

A narrowing of a bile duct may be benign, inflammatory, or require evaluation for cancer. Unexplained jaundice, itch, weight loss, worsening fatigue, or abnormal liver tests should be assessed in an organized way. CT, MRI/MRCP, endoscopic ultrasound, and ERCP can help define the problem. Where cancer is suspected, assessment is planned through a specialist multidisciplinary team.

Gallbladder cancer

What it is: An uncommon cancer that may be found unexpectedly after gallbladder removal, or on imaging as a thickened gallbladder wall or a mass.

Risk factors and symptoms: Long-standing gallstones, a calcified (porcelain) gallbladder, and larger polyps are associated with higher risk. Early disease often causes no symptoms; later signs include pain, jaundice, or weight loss.

Tests and treatment: CT, MRI, and sometimes PET-CT define the extent of disease. For localized cancer, surgery may remove the gallbladder together with part of the adjacent liver and nearby lymph nodes; chemotherapy is used according to stage.

Obstructive jaundice

What it is: Yellowing of the skin and eyes caused by a blockage to the flow of bile. Common causes are bile duct stones, strictures, and tumors of the pancreas, bile ducts, or ampulla.

Symptoms: Dark urine, pale stools, and itching are typical. Fever or chills together with jaundice may signal cholangitis and need urgent care.

Tests and treatment: Blood tests and ultrasound are followed by MRCP, CT, or endoscopic ultrasound to find the cause. Treatment addresses the cause: ERCP to clear stones or place a stent, drainage through the skin when needed, and surgery for tumors or complex strictures.

Cholangiocarcinoma (bile duct cancer)

What it is: Cancer arising from the lining of the bile ducts, inside the liver, at the liver hilum (perihilar or Klatskin tumor), or in the lower bile duct near the pancreas.

Risk factors and symptoms: Primary sclerosing cholangitis, choledochal cysts, and chronic liver disease increase risk. The typical sign is painless jaundice with itching, dark urine, and pale stools.

Tests and treatment: MRI/MRCP, CT, tumor markers, and tissue sampling by ERCP or endoscopic ultrasound are used, with bile drainage when needed. Surgery can offer cure in selected patients and may require liver resection or a Whipple procedure; chemotherapy, radiotherapy, and stenting are other options.

How assessment is organized

The aim is to identify the cause of symptoms, confirm or exclude obstruction or infection, and select the safest management plan. Please bring previous scans, reports, a medication list, and allergy information to your appointment. This page provides general information and does not replace a personal medical assessment.