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Choledocholithiasis

Low urgency
Common-

It is the presence of stones (Gallstones) in the tube that takes bile from the liver and gallbladder to the intestine.

These stones are formed by bile pigments or calcium and cholesterol salts.

It generally manifests with pain in the upper right part of the abdomen, nausea, vomiting, fever, loss of appetite, yellow skin and clay-colored stools.

After initial clinical suspicion, the diagnosis is confirmed with blood tests, abdominal ultrasound and endoscopic retrograde cholangiopancreatography (ERCP).

Treatment consists of removing the gallstones with ERCP or, if the percutaneous extraction is not possible, through surgical removal.

Bibliographic references
  1. Mustafa A Arain, Martin L Freeman. Choledocholithiasis: Clinical manifestations, diagnosis, and management. UpToDate. Mar 13, 2015.
  2. Salam F Zakko. Uncomplicated gallstone disease in adults. UpToDate. Apr 21, 2016.
  3. Warttig S, Ward S, Rogers G, Guideline Development Group. Diagnosis and management of gallstone disease: summary of NICE guidance. BMJ 2014; 349:g6241.
  4. Johnson CD. ABC of the upper gastrointestinal tract. Upper abdominal pain: Gall bladder. BMJ 2001; 323:1170.
  5. E. Ros. Enfermedades de las vías biliares. Coledocolitiasis y colangitis. Farreras Rozman. Medicina Interna. Volumen I. Duodécima edición. 360:362.
  6. Norton J. Greenberger, Gustav Paumartner. Enfermedades de la vesícula biliar y las vías biliares. Coledocolitiasis. Harrison. Principios de Medicina Interna. Volumen 2. 19ª Edición. 2083:2084.
  7. María García Ávila, Ángel Blanco Bravo. Patología urgente de la vía biliar. Manual de protocolos y actuación en urgencias. Hospital Virgen de la Salud, Complejo Hospitalario de Toledo. Tercera edición. 2010.450.
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

    Upper right abdominal pain

    Yellow tinge to skin and mucous membranes

    Abdominal pain radiating to the shoulder

    Pain for more than 20 minutes

    Nausea

Symptoms to watch out for

Fever (temperature higher than 100.4 ºF)
Change of skin coloration to yellow
Severe belly pain
Pain that does not subside with analgesics.
Reduction in the level of consciousness

Self-care

Eat a balanced diet: increase consumption of fruits, vegetables, and white meats, and reduce consumption of fatty and fried foods.
Maintain a fluid intake of 6 - 8 cups per day.
Take over-the-counter pain relievers or anti-inflammatories.
Use antiemetics if vomiting occurs.
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