<s>[INST] I have stage 2a invasive breast cancer, had surgery and a lymph node dissection. Right before my first chemo treatment my liver showed elevated levels and then after chemo my liver serum was still elevated and even more. I have had every test and scan and have not shown any more cancer but have gallstones, I have had pain in my side and vomiting whenever I take pain meds, but never had a problem with any types of food. How elevated does the liver serum have to get before I need to have my gallbladder out? And is it common to have elevated liver serum from taking pain meds when you have gallstones? [/INST] Hello! Thanks for putting your query in HCM. I am a Gastroenterologist. With the information provided by you elevation in liver enzymes may be due to cemotherapy or pain medicines you have taken.However it can be due to Gallblader also if pain is also present. So to to confirm this get ultrasound abdomen and see whether there are stones in GB, whether the wall of GB is thickened and if yes then it is due to GB.Among pain medicines take Tablet tramadol which is safe for liverAnd if it is drug induced (Chemotherapy Induced), then take tablet ursodeoxycholic acid 300mg twice a day till enzymes are normalised.Also get test for Hepatitis B and C as these are common cause of elevation of liver enzymes.I hope I have answered your query and this will help you . Wish you a good health </s>