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Cholecystectomy and Exploration of the Common Bile Duct

This webpage will give you information about a cholecystectomy and exploration of the bile duct. If you have any questions, you should ask your GP or other relevant health professional.

What are common bile-duct stones?

Common bile-duct stones are gallstones that get stuck in the common bile duct, which is a tube that connects the gallbladder to your intestines. Gallstones increase with age and in people who eat a diet rich in fat.

Common bile-duct stones can cause jaundice, severe infection of the bile ducts or inflammation of the pancreas.

What are the benefits of surgery?

You should be free of pain and able to eat a normal diet. Surgery should also prevent the serious complications that common bile-duct stones can cause.

Are there any alternatives to surgery?

An ERCP is a procedure that uses a flexible telescope to examine the bile duct and to remove stones by a sphincterotomy. A stent may also be inserted to relieve jaundice.

It is possible to dissolve the stones or even shatter them into small pieces but these techniques involve unpleasant drugs and side effects, have a high failure rate and the gallstones usually come back.

Antibiotics can be used to treat any infections of the gallbladder and common bile duct. A low-fat diet may help to prevent attacks of pain.

However, these alternatives will not cure the condition.

What does the operation involve?

The operation is performed under a general anaesthetic.

The laparoscopic (‘keyhole’) technique is usually used. Your surgeon will make several small cuts on your abdomen. They will place surgical instruments, along with a telescope, inside your abdomen and perform the operation (see figure 1).

The gallbladder and surrounding structures

Figure 1 - The gallbladder and surrounding structures

Your surgeon will first look for and remove any stones from the common bile duct. To allow bile to drain out, your surgeon will usually place a T-shaped tube into the common bile duct, with one end coming out through your skin.

Your surgeon will then separate the gallbladder from the liver, and remove it.

What complications can happen?

1 General complications of any operation

Pain
Bleeding
Infection in the surgical wound
Unsightly scarring
Blood clots

2 Specific complications of this operation

a Laparoscopic complications

Damage to internal organs
Developing a hernia near one of the cuts
Surgical emphysema

b Complications of exploring the bile-duct

Retained stones
Stones may form again
Narrowing of the common bile duct
Leaking of bile

c Complications of a cholecystectomy

Persistent pain
Diarrhoea
Inflammation in the abdomen
Bowel injury
Serious damage to the liver

How soon will I recover?

In hospital

You should be able to go home within a day or two.

Your surgeon will ask you to go to the clinic to have the T tube removed.

You should be able to return to work after three to four weeks but this may vary depending on the extent of surgery and your type of work.

You should make a full recovery and be able to eat a normal diet.

Summary

Gallstones can move into the common bile duct. An operation to remove your gallbladder and any stones in the common bile duct, should result in you being free of pain and able to eat a normal diet. Surgery should also prevent the serious complications that common bile-duct stones can cause.