Bile Duct Stones

Gallstones that form in the gallbladder are the most common cause for blocked bile ducts. Additionally, bile duct stones can develop anywhere in the biliary tract where there is bile: within the liver, gallbladder and common bile duct. Gallstones and bile duct stones are usually comprised of cholesterol or bile salts — common components of bile — that have hardened into a stone. These stones can cause sudden pain when the cystic duct in the gallbladder or the common bile duct leading from the liver is blocked. Virginia Mason gastroenterologists treat this common problem in both adults and children with minimally invasive endoscopic technology.

Removal of bile duct stones

Stones that are lodged in the bile duct can cause serious problems and need to be removed either surgically, or by means of an endoscope (a flexible instrument that is passed down through the gastrointestinal tract). If your doctor suspects a gallstone may be lodged in the bile duct and it cannot be detected using ultrasound, they may request an investigation called endoscopic retrograde cholangiopancreatography (ERCP).

ERCP involves looking at the bile duct through a small flexible tube called an endoscope, which is inserted into the mouth and directed carefully through the oesophagus and stomach, down into the duodenum (where the opening to the bile duct can be seen). A dye is then injected through the tube and into the bile duct and X-ray images taken to demonstrate any blockages that may be present.

If gallstones are found to be blocking the bile ducts, they can be removed during the ERCP procedure. This involves passing a small instrument through the endoscope and making a small cut in the lower part of the bile duct (called endoscopic sphincterotomy). This will allow the doctor to remove stones by catching them in a tiny basket and removing them through the endoscope. Alternatively, with bile duct entrance widened by the cutting, the stones are freed up to pass into the small intestine, from where they will continue through the digestive system and exit the body.