Bile duct stones are stones that have lodged in the common bile duct. The common bile duct carries bile from the liver and gallbladder to the small intestine. (Bile helps your body digest fats.) The stones are gravel-like deposits that form from cholesterol or other substances in bile. Small stones can leave the gallbladder through a small duct that empties into the common duct.
The gallbladder is a small sac that lies under the liver on your right side. It is part of the digestive system. It stores the bile made by the liver.
Most gallstones and duct stones are made of cholesterol in the bile. Usually acids in bile keep cholesterol from forming into stones. If the amount of cholesterol in the bile increases beyond the ability of acids to keep a balance, the cholesterol crystallizes and forms a stone. Some bile duct stones result from infection in the bile duct or liver.
Stones usually form in the gallbladder, but they may form in the common bile duct. When stones form in the common bile duct or move from the gallbladder into the common bile duct and become lodged in the duct, the condition is called choledocholithiasis.
Pressure from stones blocking the duct makes it hard for the liver and gallbladder to work normally. As a result, if you have stones in the bile ducts, you may have sudden pain on the right side of your abdomen and you may notice that your skin looks yellow.
Bile duct stones happen more often in people who are obese, have diabetes, or are taking drugs to lower cholesterol.
The symptoms of bile duct stones include:
Your healthcare provider will ask about your symptoms and do a physical exam.
He or she may order lab tests to look for signs of bile duct blockage. In addition, these tests may be performed:
Possible treatments are:
Laparoscopic surgery is done through several small cuts in the belly rather than open surgery with a large incision. A laparoscope is a thin metal tube with a light and tiny camera. Your provider can put the scope and tools into your abdominal cavity through the small cuts.
Rarely, in complicated cases, open surgery (with bigger cuts in the belly) is needed to safely remove the stones.
If there is any question that stones may still be in the common bile duct, your provider will put a tube called a T-tube in the common duct. The T-tube is used to explore and drain the common duct. A cholangiogram (a special X-ray using dye) can be done through the T-tube. If more stones are seen, they will be removed. The tube may be left in place and another X-ray may be done 7 or 8 days after surgery. If more stones are then found, a radiologist can remove the stones. If no stones are seen with the cholangiogram and bile is flowing properly, the T-tube may be clamped overnight and removed the next day. However, your surgeon may decide to keep the T-tube in longer.
During surgery a sample of your bile will be checked for infection in the biliary tract. If you have an infection, you may be given an antibiotic after the operation.
The effects of this condition will last as long as there are stones in the bile duct and cause problems in the liver and gallbladder.
