Common Bile Duct Stones
CBD Stones — Causes, Symptoms & ERCP Treatment
Overview
Common bile duct (CBD) stones are gallstones that have migrated from the gallbladder into the common bile duct, or formed directly in the duct. They can block the flow of bile, causing jaundice, infection, and pancreatitis.
Symptoms
- Jaundice (yellow skin and whites of eyes)
- Dark, tea-colored urine
- Pale, clay-colored stools
- Severe upper abdominal pain
- Fever and chills (cholangitis)
- Nausea and vomiting
Causes & Risk Factors
- Migration of gallstones from gallbladder
- Primary CBD stone formation
- Bile duct strictures
- Biliary infection
Diagnosis
- Liver function tests (elevated bilirubin, ALP)
- Ultrasound (dilated bile ducts)
- MRCP (most accurate non-invasive test)
- EUS (Endoscopic Ultrasound)
- ERCP (diagnostic and therapeutic)
Treatment Options
- ERCP with sphincterotomy and stone extraction
- Laparoscopic CBD exploration
- Biliary stenting for drainage
- Antibiotics for cholangitis
⚠️ When to Seek Immediate Treatment
- Jaundice (yellow skin or eyes)
- High fever with abdominal pain
- Severe pain with vomiting
- Dark urine and pale stools together
Frequently Asked Questions
Is ERCP the only treatment for CBD stones?
ERCP is the first-line treatment for most CBD stones. In some cases, laparoscopic CBD exploration during gallbladder surgery may be performed.
Can CBD stones recur after ERCP?
CBD stones can rarely recur (5–10% over 10 years). Regular follow-up and gallbladder removal (if not done) reduces recurrence risk.