Common Bile Duct Stones
Common bile duct stones refer to stones that have migrated from the gallbladder into the main bile duct or formed there. When they cause obstruction, bile flow from the liver to the intestine is impaired and jaundice, dark urine, pale stools, pruritus, right upper abdominal pain and fever may appear. In some patients the stone may also affect the pancreatic duct and cause pancreatitis. Diagnosis is based on liver function tests, elevated bilirubin, ultrasound and MRCP. Treatment typically begins with ERCP to clear the stone, followed by laparoscopic gallbladder surgery in suitable patients.
Common bile duct (CBD) stones are stones that have migrated from the gallbladder into the main bile duct or formed there. They can present with jaundice, dark urine, pale stools, abdominal pain, fever and sometimes pancreatitis. Diagnosis is based on blood tests and MRCP. Treatment is usually ERCP followed by laparoscopic gallbladder surgery in suitable patients.
Symptoms
- Jaundice (yellowing of the skin and eyes)
- Dark urine
- Pale stools
- Right upper abdominal pain
- Fever, chills
- Nausea, vomiting
- Itching in some patients
Diagnosis
Liver function tests typically show elevated ALP, GGT and bilirubin. Ultrasound may reveal a dilated bile duct but does not always show the stone itself. MRCP is a special MRI scan that provides detailed imaging of the biliary tree and plays a key role in diagnosis.
Treatment
ERCP is an advanced endoscopic procedure that allows the stone to be removed from the bile duct via the mouth. After clearing the duct, laparoscopic surgery is planned for the source — the gallbladder — in suitable patients. Severe cholangitis or obstructive jaundice may require urgent management.
Comparison table
| Condition | Symptom | Required test | Possible approach | Urgency |
|---|---|---|---|---|
| Gallstones | Pain after fatty meals, bloating | USG, blood tests | Follow-up or surgery | Depends on symptoms |
| Cholecystitis | Prolonged right upper abdominal pain, fever | USG, CRP, WBC | Urgent evaluation / surgery | High |
| CBD stones | Jaundice, dark urine | MRCP, bilirubin | ERCP ± surgery | High |
| Liver cyst | Usually asymptomatic | USG, CT/MRI | Follow-up or surgery | Low–Moderate |
| Hydatid cyst | Right upper abdominal fullness, pain | USG, CT/MRI, serology | Medication ± surgery | Moderate |
When to go to the emergency department
- Jaundice + fever + abdominal pain (Charcot's triad of cholangitis)
- Confusion
- Low blood pressure
- Persistent vomiting
Frequently Asked Questions
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Share your existing ultrasound, MRCP, CT/MRI, blood tests or discharge summary to receive preliminary information about the process. A definitive evaluation is only possible after physical examination and the necessary investigations.
The information on this page is provided for general patient education only and does not replace diagnosis, treatment or any surgical decision. An assessment appropriate for you can only be made after a clinical examination and the necessary investigations.