Hi. Thanks for your query. Noted the history and understood the concerns. This looks to be a complex problem as you already had you gallbladder out and still have pain in the right upper abdomen hence other causes should also be looked for. Other symptoms like tiredness, itchy palms and puffy ankles can be due to the following reasons: Each can have individual reason or can be combined reasons like anemia, hypoproteinemia, Multivitamin and mineral deficiency and may be some disease or disorder underlying beneath which needs a proper clinical evaluation, examination and investigations by a Doctor so that a proper diagnosi can be done and managed as per the causes found as a general treatment with Hemetemics, multivitamins and minerals and so on. Proper clinical evaluation will also help to get a follow up.