Choledocholithiasis (also called bile duct stones or gallstones in the bile duct) is the presence of a gallstone in the common bile duct. Gallstones usually form in your gallbladder. The bile duct is the small tube that carries bile from the gallbladder to the intestine.
The gallbladder is a pear-shaped organ below your liver in the upper right side of your abdomen. These stones usually remain in the gallbladder or pass through the common bile duct unobstructed.
However, about 15 percent of all people with gallstones will have gallstones in the bile duct, or choledocholithiasis
Gallstones in the bile duct may not cause symptoms for months or even years. But if a stone becomes lodged in the duct and obstructs it, you may experience the following:
When a gallstone is stuck in the bile duct, the bile can become infected. The bacteria from the infection can spread rapidly, and may move into the liver. If this happens, it can become a life-threatening infection. Other possible complications include biliary cirrhosis and pancreatitis
If you have symptoms, a doctor will want to verify the presence of a gallstone in the common bile duct. He or she may use one of the following imaging tests:
Treating gallstones in the bile duct focuses on relieving the blockage. These treatments may include:
The most common treatment for gallstones in the bile duct is Endoscopic Retrograde Cholangio-Pancreatography (ERCP). During a ERCP procedure, a balloon- or basket-type device is inserted into the bile duct and used to extract the stone or stones. About 85 percent of bile duct stones can be removed with BES.
If a stone does not pass on its own or cannot be removed with BES, doctors may use lithotripsy. This procedure is designed to fragment stones so they can be captured or passed easily.
Patients with gallstones in the bile duct and gallstones still in the gallbladder may be treated by removing the gallbladder. While performing the surgery, your doctor will also inspect your bile duct to check for remaining gallstones.
If stones cannot be removed completely or you have a history of gallstones causing problems but do not wish to have your gallbladder removed, your doctor may place biliary stents (tiny tubes to open the passage). These will provide adequate drainage and help prevent future choledocholithiasis episodes. The stents can also prevent infection
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