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If the gallbladder is extremely inflamed, infected, or has large gallstones, the abdominal approach (open cholecystectomy) is recommended. A small incision is made just below the rib cage on the right side of the abdomen. The liver is moved to expose the gallbladder. The vessels and tubes (cystic duct and artery) to and from the gallbladder are cut and the gallbladder is removed. The tube (common bile duct) that drains the digestive fluid (bile) from the liver to the small intestine (duodenum) is examined for blockages or stones. A small flat tube may be left in for several days to drain out fluids if there is inflammation or infection.

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