Bile Duct Stones | Digestive Health | Loyola Medicine

Bile Duct Stones

Overview and Facts about Bile Duct Stones

Bile duct stones, more formally called choledocholithiasis, occur when there is a gallstone in the common bile duct. Gallstones usually form in the gallbladder, but these bile duct stones happen to about 15 percent of all people with gallstones.

There are two types of gallstones that occur with choledocholithiasis: cholesterol gallstones and pigment gallstones. Cholesterol gallstones are the more common of the two.

Symptoms and Signs of Bile Duct Stones

It could be months or even years before you notice the signs and symptoms of a bile duct stone. The common symptoms are:

  • Clay-colored stool
  • Fever
  • Jaundice, which is a yellowing of the skin and eyes
  • Loss of appetite
  • Pain in the right upper abdomen or middle upper abdomen
  • Vomiting and nausea

The pain from this digestive health condition can be unpredictable. It can start mildly, then suddenly become severe. Seek emergency medical treatment if you are experiencing this type of pain.

Causes and Risk Factors of Bile Duct Stones

The causes and risk factors for bile duct stones depend on the type of gallstone involved. In general, health professionals believe cholesterol gallstones are caused by bile that has:

  • Not enough bile salts
  • Too much bilirubin, which is formed by the liver when red blood cells break down
  • Too much cholesterol

Researchers are less confident about the causes of pigment stones, but they seem to happen to people with:

  • Cirrhosis of the liver
  • Hereditary blood issues in which the liver makes too much bilirubin, namely Gilbert’s syndrome
  • Infections in the biliary tract

You may be at an increased risk for developing bile duct stones if you have any of the following characteristics:

  • A low-fiber, high-calorie, high-fat diet
  • Fasting for extended periods of time
  • Lack of exercise
  • Obesity
  • Pregnancy
  • Rapid weight loss

If the bacteria from the infection caused by a gallstone moves into the liver, a deadly infection may occur. Other complications can include biliary cirrhosis and pancreatitis.

Tests and Diagnosis of Bile Duct Stones

If you have symptoms of bile duct stones, your doctor will want to locate and officially diagnose the problem as a gallstone in the common bile duct. Imaging tests for doing this may include:

  • CT scan
  • Endoscopic ultrasound, which involves a tube being inserted in your mouth to view your digestive system
  • MRCP, which is an MRI of the gallbladder, bile ducts, and pancreatic duct

Blood tests may also help to test for and diagnose this digestive health condition.

Treatment and Care for Bile Duct Stones

Reducing the blockage caused by a bile duct stone is the main treatment goal. Options for achieving this may include:

  • Extracting the stone as a whole. This is the most common treatment. It involves putting a balloon or basket-like device into the bile duct to remove the stone or stones.
  • Fragmenting the stone and removing pieces
  • Surgery to remove the gallbladder altogether
  • Surgery to create more room for the stone to pass