The presence of a gallstone in the common bile duct is called choledocholithiasis. This can lead to an infection of the gallbladder or blockage of the flow of bile from the liver.
Some of the common symptoms are severe pain in the right or mid-abdomen that can radiate to the back, fever, nausea, vomiting, change in the color of stool, change in the color of urine or jaundice (yellowing of the skin or eyes).
HOW IS IT DIAGNOSED?
There are many studies that can help diagnose choledocholithiasis. Your doctor may order an ultrasound, CAT (computerized axial tomography) scan, HIDA (hepatobiliary iminodiacetic acid) scan, MRCP (magnetic resonance cholangiopancreatography) or blood work. Different studies are better for different situations and your doctor can help order the correct test.
WHAT IS THE TREATMENT?
If a patient has choledocholithiasis, the stones must be removed from the bile ducts and the gallbladder should also be surgically removed. The stones in the common bile duct can be removed with a procedure called an ERCP (endoscopic retrograde cholangiopancreatography) which is performed by a gastroenterologist. Surgical removal of the gallbladder by a surgeon (cholecystectomy) can be performed before or after the ERCP. Sometimes contrast dye is used in the operating room to help see if there are any stones in the common bile duct. This is called an intra-operative cholangiogram and can help see if gallstones are causing a blockage. Patients are usually admitted to the hospital for antibiotics and these procedures if they have choledocholithiasis. If patients are not healthy enough for surgery, then placement of a drainage tube into the gallbladder is another treatment performed by an interventional radiologist. Medicine alone does not usually help treat choledocholithiasis.