What Are Bile Duct Stones?
Bile produced in the liver normally flows through the bile ducts into the intestine.
Gallstones from the gallbladder or liver can move into the bile ducts, or stones can form within the bile ducts themselves. The source text states that approximately 15% of bile duct stones form within the bile ducts rather than coming from elsewhere.
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Symptoms of Bile Duct Stones
- Repeated pain in the upper abdomen.
- Loss of appetite or vomiting.
- Recurrent abdominal pain with jaundice.
- Bile duct infection (cholangitis).
- Pancreatitis caused by blockage near the opening of the bile duct and pancreatic duct.
Diagnosis of Bile Duct Stones
- Liver function tests.
- Alkaline phosphatase.
- Bilirubin, AST, ALT.
- Abdominal Ultrasound: Ultrasound may show:
- Stones in the bile ducts.
- Widening of the bile ducts.
- Narrowing of part of the bile ducts.
- MRCP: MRCP is an important noninvasive test for evaluating the bile ducts. It can also show:
- The location of one or more stones in the entire biliary system (the inside and outside of the liver).
- The location of the stones and the narrowing or widening of the duct can be determined.
- ERCP: can identify the location of bile duct stones.
Complications of Bile Duct Stones
Possible complications include:
- Obstructive jaundice (biliary obstruction).
- Cholangitis.
- Pancreatitis.
- Secondary biliary cirrhosis.
- Choledochoduodenal fistula.
Treatment of Bile Duct Stones
The main goal is to remove the stones and restore normal bile flow.
- ERCP and stone extraction.
- Surgery (choledocholithotomy).
- Biliary Reconstruction, when bile duct is severely narrowed or blocked.
Conclusion
- Bile duct stones should be treated promptly.
- Long-standing gallstones or liver stones should not be ignored because stones can move into the bile ducts or may also cause stones to form in the bile duct by itself.
- If bile duct stones occur together with bile duct narrowing, appropriate treatment may be needed to restore normal bile flow.
- When bile duct stones are associated with significant narrowing of the bile duct, the possibility of an underlying bile duct tumor or cancer should also be considered and properly evaluated.