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  • Image of Dr. Agapay and Dr. Glenn
  • Image of Dr. Agapay and Dr. Glenn's Office
  • Image of Dr. Agapay and Dr. Glenn's Office
  • Image of Dr. Agapay and Dr. Glenn's Office
  • Image of Dr. Agapay and Dr. Glenn

Gallbladder and Biliary Tract Conditions

The biliary tract includes the gallbladder and bile ducts inside and outside the liver. Bile is a fluid made by the liver that helps your body digest fat and eliminate excess cholesterol. Common gallbladder conditions are gallstones or inflammation of the gallbladder. While gallstones are sometimes painless, some gallstones can affect the gallbladder function and cause symptoms. In this case, surgery may be necessary.

Fortunately, advances in laparoscopic surgical techniques have made it possible for this disease to be treated in a manner that minimizes pain and complications. Highly skilled surgeons, Allen A. Agapay and Jordan J. Glenn, use the latest technology to provide the best treatments available.

Common gallbladder problems include the following:

  • Gallstones: These are usually made of hardened cholesterol. They can range in size from as small as a grain of sand to as large as a golf ball.
  • Polyps: These can be a precursor to rare gallbladder cancer.
  • Sludge: An accumulation of particulate matter in the bile.
  • Biliary Dyskinesia: This is when the gallbladder does not empty normally or causes pain when emptying.
  • Cholecystitis: Inflammation of the gallbladder. This can be caused by gallstones or biliary dyskinesia.


  • Pain (often severe) under the ribs on the right, especially after eating greasy foods
  • Nausea or vomiting
  • Excessive gas and bloating
  • Inability to tolerate fatty foods


  • Abdominal ultrasound: This is the test most often used to detect gallstones. This noninvasive test uses painless sound waves to "look at" the gallbladder. It can also be used to evaluate the health of the liver and indicate if there are signs of cholecystitis.
  • HIDA scan with CCK injection (cholescintigraphy): During this test, radioactive dye is injected intravenously. Observation of how the dye travels through the bile ducts, into the gallbladder and into the small intestine, helps your doctor identify inflammation and other gallbladder problems such as biliary dyskinesia.
  • Endoscopic retrograde cholangiopancreatography (ERCP): This test employs a combination of endoscopy and xray. A small flexible camera is put through the patient's mouth, into the stomach and then into the small intestine. A tiny catheter is then placed into the bile duct. Dye is injected through the tube, which enables x-rays to visualize the gallbladder and its ducts.
  • Magnetic Resonance Cholangiopancreatography (MRCP): This non-invasive, advanced imaging test uses an MRI to evaluate the biliary and pancreatic ducts and identify any gallstones lodged in the ducts around the gallbladder.


If you have severe symptoms, you may need surgery to remove your gallbladder. Gallbladder removal is known as a cholecystectomy. While the gallbladder performs an important function, it is not a necessary organ. If the gallbladder is removed, bile can move directly from the liver to the small intestine.

Doctors Agapay and Glenn offer minimally invasive surgical options to treat gallbladder conditions. This skilled team of surgeons uses the latest technology to offer the best treatments available.

  • Laparoscopic Cholecystectomy: is a minimally invasive procedure in which the gallbladder is removed using only four small incisions in the abdomen. A laparoscopic cholecystectomy is typically performed as an outpatient procedure under general anesthesia.
  • Robotic Cholecystectomy: This is a minimally invasive procedure for gallbladder removal during which the surgeon controls robotic arms with attached surgical instruments. The robotics enable very precise surgical control. The procedure can usually be done through a single incision in the belly button, so recovery time is swifter than with a standard laparoscopic cholecystectomy, with a better cosmetic result.