What is choledocholithiasis?
Choledocholithiasis is defined as small stones in the gallbladder falling into the bile duct or, rarely, stone formation in the bile duct. It is a serious disorder that can cause obstruction in the bile ducts and inflammation of the pancreas. Therefore, urgent intervention is required to remove the stone from the bile ducts endoscopically.
What are the causes of choledocholithiasis?
Disorders such as high estrogen levels, pregnancy, hormone therapy, birth control pills, obesity, and diabetes can lead to stone formation in the gallbladder, which can indirectly cause stones to fall into the bile duct. Choledocholithiasis is more common in women and over the age of 40.
What are the symptoms of choledocholithiasis?
Small stones do not cause many symptoms. However, pain that occurs in the upper right part of the abdomen and spreads to the shoulder, especially after meals is among the important symptoms of choledocholithiasis. Additionally, symptoms such as nausea, vomiting, fever, chills, jaundice of the skin and whites of the eyes, dark urine and light-colored stools may also be observed.
How is choledocholithiasis diagnosed?
In patients presenting with complaints suggestive of bile duct stones, a detailed history of the patient is first taken. Then, methods such as ultrasonography, computerized tomography (CT), magnetic resonance (MRI), and endoscopic retrograde cholangiopancreatography (ERCP) are used as radiological examinations. As blood tests, bilirubin (total and direct), alkaline phosphatase, AST, ALT and GGT values, which show liver and gallbladder function, are checked.
How is choledocholithiasis treated?
Stones in the gallbladder are usually noticed incidentally. Small and rare gallstones can be monitored without any surgery; however, some invasive methods or surgery are required for stones that pass from the sac to the duct and cause complaints. For this, sphincterotomy (widening of the canal opening) is most commonly performed with ERCP. During ERCP, the liver and pancreatic ducts are visualized endoscopically and a tube with a light at the end is used. To remove the stone, a small incision called sphincterotomy is made with an endoscopic device and this channel is emptied into the small intestine. Other surgical methods include removing the gallbladder and the stone in the duct by closed or open surgery.
