This problem refers to the presence of stones within the common bile duct. These stones usually come from the gallbladder. It is therefore considered a complication of gallstones. Rarely are the stones formed in the bile duct itself.
The most common symptom is pain. This is due to the stone causing blockage of the bile duct.
Along with the pain, because of the blockage of the bile duct, the bile cannot flow into the small intestine. This then results in jaundice, and injury to the liver. There will be a yellow discoloration of the person’s eye. This person will also notice the urine to be dark-coloured (or tea-colored), and the stools to be pale in colour.
When the bile duct is blocked, it becomes prone to infection. Such infection can be life-threatening. The person will experience high fever, along with chills and shivering. This condition is called cholangitis.
Any stone in the bile duct can also cause injury and inflammation to the pancreas. This condition is called pancreatitis. It can also lead to death if the pancreas inflammation is severe.
The person with bile duct stones will usually present as an emergency, due to the sudden or intense abdominal pain. This person will either seek urgent help at his family doctor or at an Accident & Emergency Department.
Sometimes, the bile duct stones do not cause symptoms. Such cases are only detected when the person goes for a check-up and finds some abnormalities in the liver function test. Because of the abnormal readings, the doctor will usually ask for some form of liver scan.
Unlike the situation with gallbladder stones where surgery is recommended only when a person has symptoms, for stones in the common bile duct, treatment is highly recommended even if the person claims he has no symptoms. This is because of the potential dire consequences of common bile duct stones.
There are 2 main options for the removal of common bile duct stones.
1. Laparoscopic Common Bile Duct Exploration (LCBDE)
LCBDE is one of the techniques to surgically remove common bile duct stones. The gallbladder is usually removed at the same time, since most of the bile duct stones originate from the gallbladder. It is a surgical operation performed through small incisions. Typically, 4 small incisions are needed.
2. ERCP Followed by Laparoscopic Cholecystectomy
ERCP is a special endoscopic procedure which allows the doctor to remove bile duct stones. In this method, there are 2 steps to it
Step 1
The patient will have to undergo an endoscopy called an ERCP, during which the endoscopist will widen the bile duct opening in the small intestine (sphincterotomy). The endoscopist will then attempt to remove the stone in the bile duct.
Step 2
If step 1 is successful, the patient then proceeds to step 2 to remove the gallbladder. This is usually done by the keyhole technique called the laparoscopic cholecystectomy.
Step 1 and 2 are usually performed on different days. Hence, the disadvantages of this method of treating bile duct stones are
– 2 separate procedures, each with its own risks
– 2 separate days, hence the treatment period may be prolonged.
Most bile duct stones originate from the gallbladder. Gallstones are very common. Gallstones can pass from the gallbladder into the bile duct. This is because the gallbladder, being a muscular bag, can squeeze the gallstone within it into the bile duct when it contracts. This will usually trigger a painful attack called biliary colic.
Stones can also form in the bile duct itself, but this is uncommon.
Less than 10% of bile duct stones are formed in the bile duct itself. Some of the risk factors for stones forming in the bile duct are:
Colorectal & General Surgeon
Upper Gastrointestinal, Bariatric & General Surgeon
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Our clinics will be closed from 16 – 18 Feb for CNY
Our clinic at Mt Alvernia Medical Centre A will be relocating from #06-05 to #03-03 (within the same building) on Friday, 26 Sep afternoon.
Our telephone line 6353 4855 will be temporarily unavailable from 12:00pm – 6:00pm on 26 September. During this period, you may reach out to our other clinics for assistance:
We will begin operations at our new premises (#03-03) from Tuesday, 30 Sep onwards.
We look forward to serving you at our new clinic!
Nexus Surgical clinics at Mt Elizabeth Novena Specialist Centre, Gleneagles Medical Centre, Parkway East Medical Centre and Mt Alvernia Medical Centre will be closed on 28 January 2025 for Lunar New Year celebrations, while our clinic at Mt Elizabeth Orchard Medical Centre remains open from 0900-1300 hours on 28 January 2025.
Please leave a message in our voice mails and we will respond to you as soon as we can when we resume our clinics on 31 January 2025. If you require any urgent assistance, kindly go to the Urgent Care Centre of any hospitals or contact your doctor through the Emergency Answering Service. Our team at Nexus Surgical would like to take this opportunity to wish you and your loved ones a Happy & Prosperous Lunar New Year with good health in the Year of the Snake!
Nexus Surgical will be away from 17 to 20 October 2024 for our Annual Company Retreat. The aim of our retreat is to review and to recharge, so that we may serve you better.
Our clinics at Mount Elizabeth Orchard, Mount Elizabeth Novena, Mount Alvernia and Parkway East hospitals will therefore be closed during this period. In the meantime, if you require any urgent assistance, kindly contact us through our Answering Service at +65 6333 5550.
We thank you for your understanding and patience for any inconvenience.
