Skip to main content
Update Location

My Location

Update your location to show providers, locations, and services closest to you.

Enter a zip code
Or
Select a campus/region
(352) 733-0111

Choledocholithiasis

Definition

Choledocholithiasis is the presence of at least one gallstone in the common bile duct. The stone may be made up of bile pigments or calcium and cholesterol salts.

Alternative Names

Gallstone in the bile duct; Bile duct stone

Causes

About 1 in 7 people with gallstones will develop stones in the common bile duct. This is the small tube that carries bile from the gallbladder to the intestine.

Patient Education Video: Gallstones

Risk factors include a history of gallstones. However, choledocholithiasis can occur in people who have had their gallbladder removed.

Symptoms

Often, there are no symptoms unless the stone blocks the common bile duct. Symptoms may include:

  • Pain in the right upper or middle upper abdomen for at least 30 minutes. The pain may be constant and intense. It can be mild or severe.
  • Fever.
  • Yellowing of skin and whites of the eyes (jaundice).
  • Loss of appetite.
  • Nausea and vomiting.
  • Clay-colored stools.

Exams and Tests

Tests that show the location of stones in the bile duct include the following:

Your health care provider may order the following blood tests:

Treatment

The goal of treatment is to relieve the blockage.

Treatment may involve:

  • Surgery to remove the gallbladder and stones
  • ERCP and a procedure called a sphincterotomy, which makes a surgical cut into the muscle in the common bile duct to allow stones to pass or be removed

Outlook (Prognosis)

Blockage and infection caused by stones in the biliary tract can be life threatening. Most of the time, the outcome is good if the problem is detected and treated early.

Possible Complications

Complications may include:

When to Contact a Medical Professional

Call your provider if:

  • You develop abdominal pain, with or without fever, and there is no known cause
  • You develop jaundice
  • You have other symptoms of choledocholithiasis

Gallery

Digestive system
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Kidney anatomy
The kidneys are responsible for removing wastes from the body, regulating electrolyte balance and blood pressure, and the stimulation of red blood cell production.
Digestive system
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Digestive system
The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.
Gallbladder
The gallbladder is a muscular sac located under the liver. It stores and concentrates the bile produced in the liver that is not immediately needed for digestion. Bile is released from the gallbladder into the small intestine in response to food. The pancreatic duct joins the common bile duct at the small intestine adding enzymes to aid in digestion.
Gallbladder anatomy
The gallbladder is located in the abdomen, on the right side, underneath the liver. The gallbladder stores bile produced by the liver and delivers it to the first part of the small intestine (duodenum), where it aids in the digestion of fat.

References

Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.

Li S, Zenlea T. Choledocholithiasis. In: Ferri FF, ed. Ferri's Clinical Advisor 2022. Philadelphia, PA: Elsevier; 2022:368-369.

Radkani P, Hawksworth J, Fishbein T. Biliary system. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. Philadelphia, PA: Elsevier; 2022:chap 55.

Last reviewed April 20, 2021 by Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team..

Related specialties

Our experts