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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

Tests that show the location of stones in the bile duct include the following:

Your health care provider may order the following blood 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

Complications may include:

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.

Review Date:4/20/2015
Reviewed By:Subodh K. Lal, MD, gastroenterologist at Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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Health
Outcome Data

No data available for this condition/procedure.

Read More

Biliary system

Cholangitis

Cirrhosis *

Gallstones *


* Has Related Health Outcome Information

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