How Choledocholithiasis Is Treated

Stone Extraction

Removal of the gallbladder is only employed where other techniques have failed. As highlighted earlier, gallstones are incredibly stubborn, and they will rarely go away on their own. In cases where they cause severe symptoms, a surgeon can employ stone extraction techniques to remove them.

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the standard procedures surgeons use to remove gallstones that have blocked ducts. During the procedure, an endoscope is inserted into your gastrointestinal tract through the mouth. Once it reaches the duodenum, the surgeon identifies the affected bile duct, and an instrument on the endoscope makes a small incision on the duct to remove the gallstone.

It’s worth it to note gallstones can still form even after the gallbladder has been removed. These stones may form in a few weeks, months, or even years after cholecystectomy. However, the two-step ERCP procedure has proved successful in removing gallstones that keep reoccurring.

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Sphincterotomy

The contents of the liver, gallbladder, and the pancreas drain into the small intestines through ducts. The ducts that originate from the gallbladder and the liver are known as biliary ducts, while the duct originating from the pancreas is known as pancreatic duct. The pancreatic and bile duct join together to form the common duct just before they drain into the bowel.

The opening where the two ducts join is known as the papilla, which is surrounded by a circular muscle known as the sphincter of Oddi. A sphincterotomy is the cutting of the sphincter of Oddi to allow various treatments in the ducts. This procedure is usually painless since this region has no nerve endings. Once the muscle has been cut, the surgeon can perform other procedures such as stone removal, stent placement, balloon dilation, and tissue sampling.

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