Choledocholithiasis: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Choledocholithiasis?
Choledocholithiasis is usually treated by a gastroenterologist, a doctor who treats digestive problems. A general surgeon, a doctor who does operations, may also treat it. Blockage and infection caused by stones in the biliary tract can be life threatening, so early care matters. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is choledocholithiasis?
Choledocholithiasis means there is at least one gallstone in the common bile duct. The common bile duct is the small tube that carries bile from the gallbladder to the intestine. Bile is made by your liver. The biliary tract is made up of the gallbladder and bile ducts. It helps with digestion by releasing bile. Other names for choledocholithiasis are bile duct stone and common bile duct stone.
Gallstones are hard, pebble-like pieces of material. They are usually made of cholesterol or bilirubin. They can range in size from a grain of sand to a golf ball. About 1 in 7 people with gallstones will develop stones in the common bile duct.
Symptoms
Often, there are no symptoms unless the stone blocks the common bile duct. If it does, symptoms may include:
- pain in the right upper or middle upper belly for at least 30 minutes
- fever
- jaundice, which is yellowing of the skin and whites of the eyes
- loss of appetite
- nausea and vomiting
- clay-colored stools
The pain may be constant. It can be mild or severe. It may spread to the back near the right shoulder blade.
Causes and who gets it
Risk factors include a history of gallstones. However, choledocholithiasis can occur in people who have had their gallbladder removed. The stone may be made up of bile pigments or calcium and cholesterol salts.
Some groups are more likely to get gallstones in general:
- women (the chance may be higher with extra estrogen from pregnancy, hormone replacement therapy, or birth control pills)
- older people
- people with a family history of gallstones
- American Indians and Mexican Americans
- people with obesity, diabetes, or fast weight loss
How doctors diagnose it
Several tests can show where stones are in the bile duct. They include an abdominal CT scan and an abdominal ultrasound. An endoscopic ultrasound can also be used. Another is ERCP, a procedure that can show stones and also remove them. One more is MRCP, a special MRI scan of the bile ducts. MRCP is the most accurate test that does not cut or go inside the body.
A provider may also order blood tests. These include bilirubin and a complete blood count, which counts your blood cells. They also include liver function tests and pancreatic enzymes (amylase or lipase).
Treatment
The goal of treatment is to relieve the blockage of the common bile duct. Treatment may involve surgery to remove the gallbladder and stones. It may also involve ERCP with a sphincterotomy. This makes a cut into the muscle in the common bile duct so stones can pass or be removed.
Surgery to remove the gallbladder is called cholecystectomy. You can live normally without a gallbladder. Almost all surgeons use laparoscopy, which uses small cuts. Many of these operations are done as outpatient surgery. You may be able to go home the same day. You will probably return to normal physical activity in about a week.
An open cholecystectomy is used when the gallbladder is severely inflamed, infected, or scarred. You may need to stay in the hospital for up to a week. You will probably return to normal activity after about a month. Gallbladder surgery complications are very rare. The most common one is injury to the bile ducts, which can cause infection. Most of the time, the outcome of choledocholithiasis is good if the problem is found and treated early.
When to see a doctor
Contact a doctor if you have belly pain and there is no known cause. Also contact a doctor if you have other symptoms of choledocholithiasis. Belly pain with fever, or yellow skin or eyes, can mean a stone blocks the duct and causes infection. This can be life threatening, so get medical care right away. Complications may include infection or severe damage of the bile ducts or liver. Pancreatitis, which is inflammation of the pancreas, can also occur.
Blockage and infection caused by stones in the biliary tract can be life threatening. Call 911 or go to the emergency room if you have severe belly pain or pressure. Also go if you faint or have a sudden change in mental state, such as confusion.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Such a doctor can start your evaluation and help arrange tests. They can also coordinate care with a gastroenterologist or surgeon.
Common questions
Is choledocholithiasis serious?
It can be. Blockage and infection caused by stones in the biliary tract can be life threatening. Most of the time, the outcome is good if the problem is found and treated early.
Can you get choledocholithiasis after the gallbladder is removed?
Yes. Choledocholithiasis can occur in people who have had their gallbladder removed.
Does choledocholithiasis always cause symptoms?
No. Often, there are no symptoms unless the stone blocks the common bile duct.
What is the difference between choledocholithiasis and gallstones?
Choledocholithiasis means a gallstone is in the common bile duct. Gallstones form in the gallbladder, a small, pear-shaped organ below the liver.
Sources
- MedlinePlus - Choledocholithiasis
- National Institute of Diabetes and Digestive and Kidney Diseases - Definition & Facts for Gallstones
- National Institute of Diabetes and Digestive and Kidney Diseases - Treatment for Gallstones
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
