Gallstones and Bile Duct Stones

The function of the gallbladder is to store bile that is secreted by the liver. Following a meal, this stored bile is released into the intestine, aiding digestion. Abnormalities of bile composition can lead to the formation of gallstones. Anyone can develop gallstones, but known risk factors include being female, obese and older than 60. In most patients with gallstones, the stones are confined to the gallbladder but sometimes they appear in and block the common bile duct, the tube that transports bile from the gallbladder to the intestine. Learn more about gallstones, their risks and causes.

At Brigham and Women’s Hospital (BWH), our board certified general and gastrointestinal surgeons offer the most innovative and effective treatment for patients with bile duct stones and gallstones, performing the latest and most effective minimally invasive surgical procedures, including laparoscopic cholecystectomy.

Diagnosis of Gallstones and Bile Ducts Stones

Surgeons at BWH offer a range of procedures for diagnosing gallstones and bile duct stones:

Ultrasound
Cholecystography is an X-ray that shows the flow of contrast fluid through the intestines into the gallbladder.
Blood tests look for signs of infection, obstruction, jaundice, and/or pancreatitis.
Computed tomography scan (also called CT or CAT scan)
ERCP (Endoscopic retrograde cholangiopancreatography) involves inserting an endoscope through the stomach and into the small intestine. A special dye is injected to reveal the ducts in the biliary system. This is done through the Division of Gastroenterology, Hematology and Endoscopy
Sphincterotomy is a procedure that opens the muscle sphincter wide enough so stones can pass into the intestine.

Learn about additional diagnostic tests for liver and biliary conditions.

Treatment for Gallstones and Bile Duct Stones

Surgical Treatment

If gallstones or bile duct stones cause persistent symptoms, surgical treatment may be recommended. Surgeons at BWH are experts in all surgical approaches for gallstones and bile duct stones including traditional and minimally invasive options:

Common Bile Duct Exploration Gallstones within the common bile duct can be removed using a surgical procedure known as common bile duct exploration. This procedure can be done either laparoscopically or during open cholecystectomy.
ERCP (Endoscopic retrograde cholangiopancreatography) is an appropriate technique for removal of stones that have passed from the gallbladder and are stuck in the common bile duct. This can cause the development of jaundice or pancreatitis. When a stone is found during diagnostic endoscopy, it is typically removed by a gastroenterologist.
Open Cholecystectomy refers to surgical removal of the gallbladder. In the open procedure, general anesthesia is used. A five-inch incision is made under the right rib cage or in the upper midline, and the gallbladder is removed. Usually three to four days of hospitalization are required. A four to six week recovery period at home follows, after which patients can resume full activity. The disadvantages are the pain, the long recovery and the large incision. The advantages are that the gallbladder has been removed and there is almost no chance of further stones forming.
Laparoscopic Cholecystectomy During laparoscopic cholecystectomy your surgeon operates miniature instruments under video laparoscopic monitoring. Although general anesthesia is still used, the incisions are smaller than an inch in length. Because this procedure is less invasive, there is less pain and the recovery is more rapid than after open cholecystectomy. The procedure usually is completed in less than two hours, and most patients can be discharged from the hospital several hours afterwards. Most patients resume full activities within seven days after the operation.

Read recommendations for before and after cholecystectomy surgery.

Non-Surgical Treatment

Non-surgical methods for treating gallstones are associated with limited success rates, but may be options for patients who are not surgical candidates:

Oral Dissolution Therapy is used to attempt to dissolve the gallstones. The stones must be small, not too numerous, and not contain calcium. Less than twenty percent of patients qualify for this treatment; of those who do, only one-third respond to this form of therapy. Even among patients successfully treated, more than half develop new gallstones within five years.

What You Should Expect

You will receive a thorough diagnostic examination to evaluate if you have gallstones or bile duct stones and determine what course of treatment is needed. Careful monitoring and the involvement of an experienced general and gastrointestinal surgeon are important to the successful outcome for patients with liver and gallbladder conditions.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Weiner Center for Preoperative Evaluation for pre-operative information and tests.

The day of surgery, you will be taken care of in the operating room by surgeons, anesthesiologists and nurses who specialize in surgery for patients with gallstones or bile duct stones. After surgery you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

Learn more about your hospital stay and returning home.

Multidisciplinary Care

Brigham and Women's Hospital provides a multidisciplinary approach to patient care, collaborating with colleagues who have extensive experience in diagnosing and treating gallstones and bile duct stones. In addition, patients have full access to BWH's world-renowned academic medical community with its diverse specialists and state-of-the-art facilities.

General and Gastrointestinal Surgery Appointments and Locations

Resources

Go to our health library to learn more about gallstones and bile duct stones.

Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Visit the Weiner Center for Preoperative Evaluation.