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Bile Duct Stones

Also known as choledocholithiasis, bile duct stones are gallstones present in the common bile duct. Bile duct stones either form in the bile duct or migrate into the bile duct from the gallbladder. When gallstones formed in the gallbladder, move out through the duct of the gall bladder they get stuck in the common bile duct resulting in blockage.

Gallstone Treatment in Kerala

Causes and risk factors

The risk factors for the development of bile duct stones are:

  • Age

  • Family history and genetics

  • Dyslipidemia

  • Estrogen therapy

  • Obesity

  • Female gender

  • People consuming a low-fibre and high-fat diet

  • Lack of proper exercise and physical activity

Signs and symptoms

  • Jaundice

  • Nausea and vomiting

  • Fever

  • Severe abdominal pain

Tests and diagnosis

  • Lab and blood tests: A complete blood count, bilirubin, pancreatic enzymes and liver function tests are conducted.

  • Imaging tests:

    • Abdominal CT scan: A cross-sectional imaging of the abdomen is obtained

    • TAS: A transabdominal ultrasound is done, which uses high-frequency sound waves to capture images. The liver, kidney, spleen, gallbladder and pancreas are examined.

    • EUS: An endoscopic ultrasound consists of a flexible tube with a probe inserted through the mouth and throat for a complete examination of the upper digestive tract.

    • ERCP: The endoscopic retrograde cholangiopancreatography procedure aids in the identification of stones, tumours and narrowed bile ducts. The endoscopic tube is passed into the system through the mouth and a dye injected into the duct. X-rays are used to visualize the abnormalities.

    • MRCP: A magnetic resonance cholangiopancreatography is an MRI obtained of the gallbladder, pancreas and bile duct.


The aim of treatment is to remove the blockage. Procedures for bile duct stones include:

  • Lithotripsy: ultrasound shockwaves or LASER energy by which the stones are fragmented

  • Extraction: Endoscopic extraction or removal of bile duct stones Through the ERCP endoscope, a balloon-type device is inserted into the bile duct which aid in the extraction of stones.

  • After removal of the bile duct stones, patient should undergo removal of gallbladder. If endoscopic removal is unsuccessful, laparoscopic removal of the bile duct stone along with removal of the gallbladder should be done

Due to the placement of the organs close together, and their small size, the operation requires high levels of expertise and patience. Dr. Deepak Varma has conducted several challenging bile duct surgeries successfully.