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Common Bile Duct Stones: Health Care Problem and Incidence

  • Chapter
Multidisciplinary Management of Common Bile Duct Stones

Abstract

Choledocholithiasis, or common bile duct (CBD) stones, are a common problem in the USA and Westernized cultures. Complications of choledocholithiasis can be serious, including biliary obstruction, gallstone pancreatitis, and cholangitis. The burden of the spectrum of diseases related to stones within the biliary tree is significant. Fortunately, with advances in diagnostic and therapeutic modalities, the mortality from these complications has declined over the past three decades. The gallbladder is the source of the majority of CBD stones in Westernized cultures. These are secondary stones, composed primarily of cholesterol. Populations at higher risk of gallstone formation (and therefore at risk of developing secondary CBD stones) including Native Americans, Mexican Americans, women, elderly patients, obese patients, those with certain chronic diseases (cirrhosis, cystic fibrosis, Sickle cell disease), patients experiencing rapid weight loss (bariatric surgery patients) and critically ill patients receiving total parenteral nutrition (TPN). Primary stones occur with greater prevalence in Southeast Asian populations. These stones, called brown stones, have a higher bilirubin content than cholesterol stones and are frequently infected. Retained stones are a subtype of secondary stones left in the biliary tree after cholecystectomy. Many retained stones pass spontaneously and are asymptomatic, though a proportion of patients with retained stones go on to develop CBD stone complications with signs and symptoms similar to patients with secondary CBD stones.

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Authors and Affiliations

  1. Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Penn State Hershey Medical Center, 500 University Drive, MC H149, Hershey, PA, 17033, USA

    Joshua S. Winder M.D. & Eric M. Pauli M.D.

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  1. Joshua S. Winder M.D.
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  2. Eric M. Pauli M.D.
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Correspondence to Eric M. Pauli M.D. .

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Editors and Affiliations

  1. The Ohio State University Wexner Medical Center, Chief, Division of General and Gastrointestinal Surgery,, Department of Surgery,, Columbus, Ohio, USA

    Jeffrey W. Hazey

  2. The Ohio State University Wexner Medical Center, Director, Division of Gastroenterology, Hepatology, and Nutrition, Professor of Medicine, Department of Internal Medicine,, Columbus, Ohio, USA

    Darwin L. Conwell

  3. The Ohio State University Wexner Medical Center, Division of Vascular and Interventional Radiology, Department of Radiology, Columbus, Ohio, USA

    Gregory E. Guy

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Winder, J.S., Pauli, E.M. (2016). Common Bile Duct Stones: Health Care Problem and Incidence. In: Hazey, J., Conwell, D., Guy, G. (eds) Multidisciplinary Management of Common Bile Duct Stones. Springer, Cham. https://doi.org/10.1007/978-3-319-22765-8_2

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