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Exploration of the common bile duct

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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In order to explore, the common bile duct is opened via a longitudinal incision. An operative cholangiogram may be undertaken - this demonstrates the presence or absence of stones in the common bile duct.

Retrieval of stones is via a combination of:

  • manipulation
  • irrigation
  • grasping with stone forceps
  • use of a balloon catheter

The duct may be inspected using a choledochoscope. A sphincterotomy may be necessary to remove a stone impacted in the ampulla of Vater.

The common bile duct is closed over a T-tube which drains bile to the exterior. The main purpose of the T-tube is to allow access to the biliary tree for a further cholangiogram, usually about one week post-operatively.

Note that the use of ERCP and endoscopic sphincterotomy now provide a non-operative alternative for removal of stones in the common bile duct.


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