Bile duct stone removal

What is bile duct stone removal?

Gallstones usually form in the gallbladder, but sometimes a stone slips out and gets stuck in the bile duct — the small tube that carries bile from the liver and gallbladder to the bowel. This is called a common bile duct stone, or choledocholithiasis. A stuck stone can block bile and cause jaundice (yellow skin and eyes), pain, infection of the bile (cholangitis), or inflammation of the pancreas (pancreatitis).

The most common way to remove a bile duct stone is a camera test called ERCP. The doctor passes a camera to where the bile duct opens, makes a tiny cut, and pulls the stone out with a balloon or wire basket. Sometimes the stone is removed during keyhole surgery instead, especially if your gallbladder is being taken out at the same time.

Clearing the stone deals with the immediate blockage, but it does not remove the gallbladder, where more stones can form. For this reason, most people are advised to have their gallbladder removed afterwards to stop the problem coming back.

This is treatment for a real and sometimes serious problem, not an elective choice — but you should still understand the options, the risks, and what happens if the duct cannot be fully cleared first time.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Two ways to clear a bile duct stone

NICE supports either clearing the duct at surgery or by ERCP. The right choice depends on your scans, how unwell you are, and local expertise.

Preparing for your procedure

• You will usually be asked not to eat for about 6 hours before an ERCP; follow the exact instructions you are given.
• Tell the team about blood-thinning medicines, as these need planning around the procedure.
• Mention diabetes, heart, lung or kidney problems, dye allergy, or any chance of pregnancy (X-rays are used).
• Tell them about previous stomach or bile duct surgery, which can change how the procedure is done.
• Arrange for someone to take you home and stay with you for 24 hours after sedation; you cannot drive.
• Ask whether your gallbladder will be removed in the same admission or at a later date.

What happens

If the stone is removed by ERCP, you have sedation (sometimes a general anaesthetic). The doctor passes a camera to where the bile duct opens, injects dye, takes X-rays, then makes a tiny cut and pulls the stone out with a balloon or basket. A large stone may be broken up first. If it cannot all be removed, a stent is left to keep bile draining and a further attempt is planned.

If the stone is removed at surgery, it is usually done by keyhole (laparoscopy), often while the gallbladder is being taken out. This avoids a separate ERCP but needs a general anaesthetic.

Either way, the aim is to relieve the blockage so bile can drain and any jaundice, pain or infection settles. The team will usually tell you afterwards whether the duct was fully cleared.

Is this procedure right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

The main risk of clearing a stone by ERCP is pancreatitis. Risk is higher if the duct is difficult to enter or the stone is large. If your stone is removed surgically instead, the risks are those of a general anaesthetic and keyhole surgery. Ask which route is safer for you, and what the plan is if the first attempt does not clear the duct.

Published figures to discuss

Most bile duct stones can be cleared, but success and complications depend on stone size and number, the anatomy, and how the duct is reached. ERCP carries a real risk of pancreatitis. The figures below are cautious and taken from UK guidance and reviews; they are not guarantees for any individual.

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

If your stone is removed by ERCP there is no surgical wound, but you recover from the sedation and let your bile system settle. If it is removed surgically, recovery follows keyhole surgery. Most people improve quickly once the blockage is relieved.

• Yellowing of the skin and eyes fading over days as bile drains
• A sore throat and bloating after ERCP
• Feeling tired after sedation or anaesthetic
• Pale stools and dark urine returning to normal as the blockage clears

Aftercare

• Arrange for a responsible adult to take you home and stay overnight after sedation.
• Do not drive, drink alcohol or make important decisions for 24 hours after sedation.
• Take any antibiotics or other new medicines exactly as prescribed.
• Eat lightly at first, then return to normal food as you feel able.
• Watch for and act on the warning signs below.
• Keep follow-up appointments to confirm the duct is clear and to plan gallbladder surgery.

• Someone to drive you home and stay 24 hours
• Time off work arranged (often a few days)
• Plan agreed for blood thinners
• Understanding of whether the gallbladder is being removed and when
• Clinic and out-of-hours numbers saved
• Clear note of warning signs to watch for

⚠ Get urgent help if…

• Severe or worsening tummy or back pain (a possible sign of pancreatitis)
• A high temperature, shivering or feeling very unwell (a possible sign of bile infection)
• New or worsening yellowing of the skin or eyes
• Vomiting blood, or stools that are black and tarry
• A hard, swollen, very tender tummy
• Difficulty breathing, chest pain or fainting

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

If the stone is removed and the duct is clear, bile can drain again, and jaundice, dark urine and itching usually improve over days. The team can often confirm clearance on the X-ray taken during ERCP.

Because the gallbladder is left in place after ERCP, more stones can form and reach the duct again. This is why gallbladder removal is usually advised. Clearing the duct treats the current problem but is not a guarantee against future stones unless the gallbladder is dealt with.

Removing the stuck stone resolves that episode. Without removing the gallbladder, new stones may form and the problem can return. After gallbladder removal, bile duct stones are much less likely but not impossible. Your team should explain your individual risk and any monitoring.

Related tests, treatments or support

Bile duct stone removal is often combined with, or followed by, removal of the gallbladder (cholecystectomy). In some units the bile duct is cleared during the same keyhole operation. An MRCP or endoscopic ultrasound scan is often done first to confirm the stone before any procedure.

Follow-up & long-term care

You should know who is confirming that the duct is clear, when any stent will be changed or removed, and when your gallbladder will be removed if recommended. Report jaundice, fever or severe pain promptly rather than waiting for a routine appointment.

• If a stent was placed, it usually needs checking, changing or removing — note when.
• Follow the agreed plan for gallbladder removal to prevent further stones.
• Seek advice promptly if jaundice, pain or fever return.

Repeat, follow-on and what comes next

• A duct is not always cleared in one ERCP; a stent and a repeat are common for large stones.
• Stones can recur, especially if the gallbladder is left in place.
• Stents are usually temporary and planned for change or removal.
• If ERCP repeatedly fails, surgery or percutaneous drainage may be needed.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

• Confirmation in writing of whether the duct was cleared, and the plan if not.
• A named contact and clear warning signs, with A&E advice for severe pain or fever.
• A defined plan and timescale for gallbladder removal where recommended.
• Arrangements for any stent change or removal.
• Monitoring for early pancreatitis before discharge after ERCP.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

• Whether the stone is removed by ERCP, at surgery, or both
• Sedation or general anaesthetic and the anaesthetist's involvement
• What is done (sphincterotomy, stone removal, lithotripsy, stent)
• The operator's fee and the facility or theatre charge
• Whether you need an inpatient stay because you are unwell or jaundiced
• Whether gallbladder removal is done at the same time or separately
• Follow-up appointments and any repeat procedure or stent change

• The operator's fee and the facility/theatre fee
• Sedation or anaesthetist fees
• Cost of any stent or device used
• Whether gallbladder removal is included or quoted separately
• What happens (and what it costs) if the duct cannot be cleared and a repeat is needed
• Cost of any inpatient stay if a complication occurs
• Follow-up consultation to confirm the duct is clear

On the NHS? Bile duct stones are routinely treated on the NHS when found; private care may be chosen for speed or convenience rather than because the NHS does not provide it.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Consent traps and marketing red flags

These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.

Choosing a specialist safely

• Check the specialist is on the GMC Specialist Register for this area.
• Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
• You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
• Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
• You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Take this to your consultation. A good specialist will welcome every one of these.

• Should my stone be removed by ERCP, at surgery, or both — and which is safer for me?
• Will my gallbladder be removed, and in the same admission or later?
• What happens if the duct cannot be fully cleared first time?
• How experienced is the team at clearing bile duct stones?
• What are the warning signs that mean I should come back urgently?
• What can I do to lower the chance of further stones?
• Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
• Will you be the specialist who carries out my procedure, and who looks after me afterwards?
• What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
• What does a realistic result look like — and what can this procedure not achieve?
• What are my options, including waiting, doing nothing for now, or choosing a different approach?
• Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
• What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Find a verified specialist for bile duct stone removal

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE CG188 — Gallstone disease recommendations NHS — Gallstones: treatment BSG — ERCP Quality Improvement Programme NHS (Hull) — ERCP patient leaflet Systematic appraisal of choledocholithiasis guidelines — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.