choledocholithiasis

Definition

• Gallstone lodged in common bile duct (CBD)

Epidemiology

• Occurs in 15% of Pts w/ gallbladder stones; can form de novo in CBD due to biliary stasis

Clinical manifestations

• RUQ/epigastric pain 2° obstrxn of bile flow → ↑ CBD pressure, jaundice, pruritus, nausea
• Rarely asymptomatic

Diagnostic studies-choledocholithiasis

Treatment

• ERCP & papillotomy w/ stone extraction (± lithotripsy)
• CCY w/in 6 wk unless contraindication (>15% Pts develop indication for CCY if unRx’d)

Complications

• cholangitis, cholecystitis, pancreatitis, stricture