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Choledocholithiasis

  • Definition
    • Choledocholithiasis is the presence of at least one gallstone in the common bile duct. The stone may be made up of bile pigments or calcium and cholesterol salts.

  • Alternative Names
    • Gallstone in the bile duct; Bile duct stone

  • Causes
    • About 1 in 7 people with gallstones will develop stones in the common bile duct. This is the small tube that carries bile from the gallbladder to the intestine.

      Risk factors include a history of gallstones. However, choledocholithiasis can occur in people who have had their gallbladder removed.

  • Symptoms
    • Often, there are no symptoms unless the stone blocks the common bile duct. Symptoms may include:

      • Pain in the right upper or middle upper abdomen for at least 30 minutes. The pain may be constant or cramping. It can feel sharp or dull.
      • Fever
      • Yellowing of skin and whites of the eyes (jaundice)
      • Loss of appetite
      • Nausea and vomiting
      • Clay-colored stools
  • Exams and Tests
  • Treatment
    • The goal of treatment is to relieve the blockage.

      Treatment may involve:

      • Surgery to remove the gallbladder and stones
      • ERCP and a procedure called a sphincterotomy, which makes a surgical cut into the muscle in the common bile duct to allow stones to pass or be removed
  • Outlook (Prognosis)
    • Blockage and infection caused by stones in the biliary tract can be life-threatening. Most of the time, the outcome is good if the problem is detected and treated early.

  • Possible Complications
  • When to Contact a Medical Professional
    • Call your provider if:

      • You develop abdominal pain, with or without fever, and there is no known cause.
      • You develop jaundice.
      • You have other symptoms of choledocholithiasis.
  • References
    • Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 155.

      Jackson PG, Evans SRT. Biliary system. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. St. Louis, MO: WB Saunders; 2012:chap 55.