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Choledocholithiasis Updated 4/2011

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BASICS

  • Description
  • Epidemiology
  • Risk Factors
  • General Prevention
  • Pathophysiology
  • Etiology
  • Associated Conditions

DIAGNOSIS

  • Signs and Symptoms
  • Tests
  • Differential Diagnosis

TREATMENT

  • Medication (Drugs)
  • Surgery
  • In-patient Considerations

Ongoing Care

  • Follow-Up Recommendations
  • Prognosis
  • Complications
The following is an excerpt....
BASICS
Description
  • Stones in common bile duct (CBD)
  • 3 types: Cholesterol (majority), calcium bilirubinate or pigment, and mixed stones
  • Pigment stones may form de novo in the CBD.
  • System(s) affected: Gastrointestinal; Hepatobiliary
  • Synonym(s): CBD stones; CBD calculi
Epidemiology
Incidence
  • 700,000 cholecystectomies performed annually in US:
    • 4.6–20% of patients with gallstones have choledocholithiasis discovered at time of cholecystectomy, depending on whether routine cholangiography is used.
  • Increases with age (30–50% of patients >60 years old with gallstones have CBD stones):
    • On average, present 10 years older than cholelithiasis patients
  • Incidence of gallstones in US is 10–20%: Individuals >60 years old is up to 40%
  • Internationally, incidence is increased due to parasitic infections such as Ascaris ...

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See Also
Images >
FIG. 2.34. Choledocholithiasis. Coronal thick slab MRCP demonstrates distal common bile duct stone (arrow).Credit: John R. Leyendecker, Jeffrey J. Brown, Practical Guide to Abdominal and Pelvic MRI. Philadelphia: Lippincott Williams & Wilkins, 2004.