Bile-Duct Stones (Choledocholithiasis)

• What is a duct stone?+−

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  A stone in the common bile duct (choledocholithiasis). Most migrate from the gallbladder; fewer form in the duct itself. When the duct is blocked, bile cannot reach the intestine — pressure rises and cholangitis or pancreatitis can follow.

• Warning signs+−

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  Yellow eyes or skin, dark urine, pale stools, itch, right-upper pain, fever with rigors, and sometimes severe back pain from pancreatitis. Cholangitis is an emergency; delay can lead to sepsis.

  • Jaundice
  • Dark urine / pale stools
  • Fever with rigors (cholangitis)
  • Severe abdominal or back pain (pancreatitis concern)
• How it is diagnosed+−

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  Blood tests may show bilirubin and cholestatic enzyme rises. Ultrasound can show duct dilatation but may miss the stone itself. MRCP is non-invasive and informative. ERCP can diagnose and treat in one session.

• Treatment pathway+−

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  For symptomatic duct stones, many centers clear the duct with ERCP first, then remove the gallbladder in the same admission or soon after. That reduces the chance of further stones dropping into the duct. Selected cases may use laparoscopic or robotic common-bile-duct exploration.

More chapters in this hub

• Gallstones

  Biliary colic, silent stones, and when cholecystectomy is curative

• Acute Cholecystitis

  Fever and continuous RUQ pain — early surgery pathways

• Gallbladder Polyps

  Size, growth, and when surveillance becomes surgery

• Gallbladder Cancer

  Rare cancer — staging and tumor-board planning

• Laparoscopic Cholecystectomy

  Laparoscopic cholecystectomy: what the procedure aims to do and who it fits

• Robotic Gallbladder Surgery

  Robotic surgery: what the procedure aims to do and who it fits