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What is the bile duct? 

The bile duct is a tube that connects the liver and the intestine. Fluid from the liver (called bile) drains out of the liver and into the intestine via the bile duct.  

How did gallstones get into the bile duct? 

The gallbladder is connected to the bile duct. Occasionally gallstones fall out of the gallbladder into the bile duct.  

What problems can gallstones in the bile duct cause? 

Gallstones in the bile duct can cause a number of issues including: 

  • Pain. This is usually in the upper and right part of the tummy.  
  • Jaundice. Gallstones can block the flow of bile in the bile duct. Your skin and the whites of your eyes turn yellow. Your urine may turn a very dark colour. Your poo may turn grey and be difficult to flush away.
  • Infection of the gallbladder and liver. This causes pain and makes you feel unwell and feverish. This can be life-threatening.  
  • Acute pancreatitis. This is inflammation of the pancreas gland. This causes severe pain. This can cause serious, life-threatening problems.  
  • No symptoms at all. Sometimes people get no symptoms. It is possible that they may have had gallstones in their bile duct for a long time. 

What does bile duct exploration surgery involve? 

This involves removing the gallbladder and removing gallstones from the bile duct in one procedure. You will have a general anaesthetic (meaning you will be asleep). The operation  is usually done with keyhole surgery. Your surgeon will make 3 or 4 small cuts on your tummy. The gallbladder is removed from the liver and an x-ray or ultrasound is performed to check if there are still stones in the bile duct. Gallstones are then removed from the duct. 

How are gallstones removed from the bile duct? 

There are three ways to remove gallstones from the bile duct. 

  • A camera is inserted into an opening in the bile duct and the stones are removed with a net.   
  • A camera is inserted into an opening in the bile duct. The stones are broken into smaller pieces with shockwaves (called lithotripsy). The small pieces of gallstones are then removed with a net or left to pass by themselves.  
  • A cut is made on the bile duct. A camera is then inserted into the bile duct and the stones are removed. The cut is then closed with stiches.

How long does the operation take? 

The procedure normally takes one to two hours. The operation may take longer if the gallbladder is very inflamed or if there are multiple stones. 
You will spend several hours in hospital recovering from the operation. In total, you can expect to spend most of the day in hospital.  

How long will I stay in hospital? 

We aim to get most people home on the same day as their operation. If we make a cut on the bile 
duct we always leave a drain and keep people overnight to check that there is no leakage of bile.   

Are there any risks of bile duct exploration surgery? 

The risks are similar to having a gallbladder operation and can be found at the following link: 
Gallbladder surgery and gallstones

Risks specific to bile duct exploration surgery include: 

  • Bile leak: If we make a cut on the bile duct there is a chance that bile can leak from the cut after the operation. We leave a drain inside the tummy to check for leakage. This is a thin plastic tube that sticks out of one of your wounds. and is connected to a drain bag. 
  • Bile leaks often stop by after a few days. Sometimes the leak does not stop and you may need one (or more) ERCP procedures to help fix the leak. You will need a drain for as long as there is a bile leak. 
  • Infection of the bile duct. This is rare and can be manged with antibiotics 
  • Damage to the bile duct: This is rare. This is a very serious complication. This may require a special endoscopy procedure called an ERCP and/or major abdominal surgery to fix. 
  • Gallstones left behind in the bile duct: Sometimes it is not possible to remove the gallstones from the bile duct. Rarely a stone can be left behind. If this happens you will need an ERCP procedure to remove these stones. 

What are the options for managing gallstones? 

Yes. Other options include: 

  • An endoscopic procedure (called an ERCP) 
  • Leaving the stones alone  

What does ERCP involve? 

This involves passing a camera through the mouth into the intestine. Stones are then removed from the bile duct. This is performed in the endoscopy or radiology department. It is under sedation (where you awake but very drowsy) or general anaesthetic (where you are asleep). It is usually a day case procedure.  

What is the difference between ERCP and bile duct exploration surgery? 

ERCP is considered to be an equally effective method of removing bile duct stones. You may still need an operation in the future to get rid of your gallbladder and gallstones. Sometimes a stent is left in the bile duct and you may need another endoscopy procedure to remove this.

What happens if I leave the stone alone? 

It can be difficult to predict what will happen to bile duct stones if they are left alone.  

  • You may get no symptoms at all.  
  • If the stones are very small, they may pass out of the bile by themselves  
  • They may cause pain, jaundice, infection or pancreatitis. 

If you are experiencing any of the following symptoms, please contact your surgical team 

  • Unable to eat or drink.  
  •  Severe pain  
  • Fever 
  • Feeling unwell 
  • Skin or eyes becoming yellow  
  • Wound problems 

Contact information 

If your operation was at Heatherwood Hospital call: 

If your operation was at Wexham Park Hospital call:  

If you operation was at Frimley Park Hospital call:

If you cannot get in contact, please call 111
If you feel seriously unwell, call 999 or go to the nearest  Emergency Department

Contact us

If you have any queries relating to this information, please contact the General surgery service.

About this information

Service:
General surgery

Reference:
Y/007

Approval date:
9 January 2024

Review date:
9 January 2027

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This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.