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 then moved to expose the gallbladder. The vessels and tubes (cystic duct and artery) connected to 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 is examined for blockages or stones. If there is inflammation or infection, a small, flat tube is left inside for several days to drain out fluids.