Bile Duct Stone

Bile duct stones, or choledocholithiasis, occur when gallstones migrate from the gallbladder into the bile ducts. These stones can obstruct bile flow, leading to symptoms such as jaundice, abdominal pain, nausea, or potentially life-threatening complications like cholangitis or pancreatitis. Treatment aims to remove the stones, relieve symptoms, and prevent complications.

Treatment Options

Endoscopic Retrograde Cholangiopancreatography (ERCP):

• ERCP is the first-line treatment for bile duct stones.
• A flexible endoscope is passed through the mouth into the duodenum to access the bile duct.
• Techniques used during ERCP include:
  Sphincterotomy: A small incision is made in the sphincter of Oddi to enlarge the duct opening.
  Stone Extraction: Stones are retrieved using baskets or balloons.
  Lithotripsy: Large stones may be fragmented using mechanical, electrohydraulic, or laser lithotripsy.

Surgical Options:

• Laparoscopic Common Bile Duct Exploration: Performed when ERCP is not feasible or stones are too large.
• Open Surgery: Rarely needed, typically for complex cases or associated complications.

Percutaneous Transhepatic Cholangiography (PTC):

An interventional radiology technique used if ERCP is not possible. A catheter is inserted through the liver into the bile ducts to extract the stones or place a drainage stent.

Cholecystectomy:

Removal of the gallbladder is often performed after stone extraction to prevent recurrence, especially if stones originated from the gallbladder.