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<link rel="alternative" hreflang="en" href="https://medlineplus.gov/ency/article/000274.htm"/><meta property="og:title" content="Choledocholithiasis: MedlinePlus Medical Encyclopedia"/><meta property="og:url" content="https://medlineplus.gov/ency/article/000274.htm"/><meta property="twitter:title" content="Choledocholithiasis: MedlinePlus Medical Encyclopedia"/><meta name="twitter:card" content="summary_large_image"/><meta name="description" content="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."/><meta itemprop="description" name="description" content="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."/><meta property="og:description" content="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."/><meta property="twitter:description" content="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."/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_2.jpg"/><meta property="og:image" content="https://medlineplus.gov/images/share_ency_3.jpg"/><meta property="twitter:image" content="https://medlineplus.gov/images/share_ency_1.jpg"/>
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</div><div><span>Choledocholithiasis</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Choledocholithiasis</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Choledocholithiasis is the presence of at least one gallstone in the common bile duct. The stone may be made up of <a test="test" href="./002237.htm">bile</a> pigments or calcium and cholesterol salts.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>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.</p><p>Risk factors include a history of <a test="test" href="./000273.htm">gallstones</a>. However, choledocholithiasis can occur in people who have had their gallbladder removed.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>Often, there are no symptoms unless the stone blocks the common bile duct. Symptoms may include:</p><ul><li>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.</li><li><a test="test" href="./003090.htm">Fever</a>.</li><li>Yellowing of skin and whites of the eyes (jaundice).</li><li>Loss of appetite.</li><li><a test="test" href="./003117.htm">Nausea and vomiting</a>.</li><li>Clay-colored stools.</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Tests that show the location of stones in the bile duct include the following:</p><ul><li><a test="test" href="./003789.htm">Abdominal CT scan</a></li><li><a test="test" href="./003777.htm">Abdominal ultrasound</a></li><li><a test="test" href="./007479.htm">Endoscopic retrograde cholangiography</a> (ERCP)</li><li>Endoscopic ultrasound</li><li>Magnetic resonance cholangiopancreatography (MRCP)</li><li><a test="test" href="./003820.htm">Percutaneous transhepatic cholangiogram (PTCA)</a></li></ul><p>Your health care provider may order the following blood tests:</p><ul><li><a test="test" href="./003479.htm">Bilirubin</a></li><li><a test="test" href="./003642.htm">Complete blood count</a> (CBC)</li><li><a test="test" href="./003436.htm">Liver function tests</a></li><li>Pancreatic <a test="test" href="./002353.htm">enzymes</a> (amylase or lipase)</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>The goal of treatment is to relieve the blockage.</p><p>Treatment may involve:</p><ul><li><div>Surgery to remove the gallbladder and stones</div></li><li><div><a test="test" href="./007479.htm">ERCP</a> 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</div></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>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. </p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li>Biliary <a test="test" href="./000255.htm">cirrhosis</a></li><li><a test="test" href="./000290.htm">Cholangitis</a></li><li>Pancreatitis </li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Contact your provider if:</p><ul><li>You develop abdominal pain, with or without fever, and there is no known cause</li><li>You develop jaundice</li><li>You have other symptoms of choledocholithiasis</li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Gallstone in the bile duct; Bile duct stone</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1090t.jpg" alt="Digestive system" title="Digestive system" class="side-img"/><a href="../imagepages/1090.htm">Digestive system</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/1173t.jpg" alt="Kidney cyst with gallstones - CT scan" title="Kidney cyst with gallstones - CT scan" class="side-img"/><a href="../imagepages/1173.htm">Kidney cyst with gallstones - CT scan</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/17038t.jpg" alt="Choledocholithiasis" title="Choledocholithiasis" class="side-img"/><a href="../imagepages/17038.htm">Choledocholithiasis</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/19260t.jpg" alt="Gallbladder" title="Gallbladder" class="side-img"/><a href="../imagepages/19260.htm">Gallbladder</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/19261t.jpg" alt="Gallbladder" title="Gallbladder" class="side-img"/><a href="../imagepages/19261.htm">Gallbladder</a></li>
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/8794t.jpg" alt="Bile pathway" title="Bile pathway" class="side-img"/><a href="../imagepages/8794.htm">Bile pathway</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Fogel EL, Sherman S. Diseases of the gallbladder and bile ducts. In: Goldman L, Schafer AI, eds. <em>Goldman-Cecil Medicine</em>. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 146.</p><p>Pattni C, Zenlea T. Choledocholithiasis. In: Ferri FF, ed. <em>Ferri's Clinical Advisor 2023</em>. Philadelphia, PA: Elsevier; 2023:368-369.</p><p>Radkani P, Hawksworth J, Fishbein T. Biliary system. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. <em>Sabiston Textbook of Surgery</em>. 21st ed. St Louis, MO: Elsevier; 2022:chap 55.</p></div></div></section>
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