Bile Duct Stones
Bile duct stones (choledocholithiasis) occur when gallstones migrate into the common bile duct, causing obstruction and potentially serious complications. Prompt diagnosis and treatment are essential.
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Understanding Bile Duct Stones
Common Cause
10-15% of people with gallstones also have bile duct stones
Treatment Success
ERCP successfully removes stones in over 90% of cases
Minimally Invasive
Most stones can be removed endoscopically without surgery
Signs & Symptoms
Symptoms typically occur when a stone causes obstruction of bile flow.
- Sudden, severe pain in the upper right abdomen
- Pain radiating to the back or right shoulder
- Jaundice (yellowing of skin and eyes)
- Dark urine (tea-coloured)
- Pale, clay-coloured stools
- Fever and chills (if infection present)
- Nausea and vomiting
- Itchy skin
Risk Factors
Factors that increase the likelihood of developing bile duct stones.
- History of gallstones
- Previous gallbladder removal (stones can form in bile duct)
- Female gender
- Age over 40 years
- Obesity
- Rapid weight loss
- Pregnancy
- Certain blood disorders (sickle cell disease)
Potential Complications
Untreated bile duct stones can lead to serious, potentially life-threatening complications.
Cholangitis
Infection of the bile duct causing fever, jaundice, and abdominal pain. This is a medical emergency requiring urgent treatment.
Pancreatitis
Inflammation of the pancreas when a stone blocks the common channel of the bile and pancreatic ducts.
Biliary Obstruction
Complete blockage of bile flow leading to worsening jaundice and liver dysfunction.
Secondary Biliary Cirrhosis
Long-term obstruction can lead to liver damage and scarring over time.
Diagnosis
A combination of blood tests and imaging studies are used to diagnose bile duct stones.
Blood Tests
Liver function tests show elevated bilirubin, alkaline phosphatase (ALP), and gamma-GT (GGT). White blood cell count may be elevated if infection is present.
Ultrasound
First-line imaging to detect dilated bile ducts and gallstones. However, stones in the bile duct may not always be visible on ultrasound.
MRCP
A specialised MRI scan that provides detailed pictures of the bile ducts and can detect stones with high accuracy. Non-invasive 'road map' before treatment.
Endoscopic Ultrasound (EUS)
Highly sensitive test that can detect small stones missed by other imaging. Can be combined with ERCP for same-session treatment.
Learn more about this procedure →Treatment Options
ERCP is the primary treatment for bile duct stones, offering effective stone removal without open surgery.
ERCP Stone Removal
The gold standard treatment. A flexible endoscope is passed through the mouth to the bile duct opening. Stones are removed using a balloon or basket after sphincterotomy.
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Biliary Stenting
If stones cannot be completely removed in one session, a plastic stent is placed to maintain bile drainage and prevent complications until definitive treatment.
Learn more about this procedure →Experiencing Biliary Symptoms?
Don't delay treatment for bile duct stones. Dr. Prem Thurairajah is an experienced ERCP specialist who can provide expert evaluation and treatment.
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The information provided is for educational purposes only and should not replace professional medical advice. Please consult Dr. Prem Thurairajah for personalised diagnosis and treatment options.