Common Bile Duct Exploration

What is a common bile duct exploration?

The common bile duct is a tube that connects the liver, gallbladder, and pancreas to the small intestine. It helps deliver fluids for digestion.

A common bile duct exploration is a procedure used to see if a stone is blocking the flow of bile from your liver and gallbladder to your intestine.

When is it used?

When a stone becomes stuck in the common bile duct it may cause bile to back up into the liver. This causes jaundice. Jaundice is a condition in which the skin and the whites of the eyes become yellowish. If the stone isn't removed, the common bile duct may become infected and need emergency surgery. Common bile duct exploration is often done during surgery to remove the gallbladder.

An alternative, nonsurgical procedure is an endoscopic retrograde cholangiopancreatography (ERCP). Or you may choose not to have treatment, recognizing the risks of your condition. You should ask your health care provider about these choices.

How do I prepare for a common bile duct exploration?

Plan for your care and recovery after the operation. Allow for time to rest and try to find people to help you with your day-to-day duties.

Follow your health care provider's instructions about not smoking before and after the procedure. Smokers heal more slowly after surgery. They are also more likely to have breathing problems during surgery. For this reason, if you are a smoker, you should quit at least 2 weeks before the procedure. It is best to quit 6 to 8 weeks before surgery. Also, your wounds will heal much better if you do not smoke after the surgery.

Follow any other instructions your provider gives you. Eat a light meal, such as soup or salad, the night before the procedure. Do not eat or drink anything after midnight and the morning before the procedure. Do not even drink coffee, tea, or water.

What happens during the procedure?

You will be given general anesthesia. It will relax your muscles, put you to sleep, and prevent you from feeling pain during the operation.

The surgeon makes a cut in your abdomen and locates the common bile duct. Then he or she injects a liquid dye into the duct and takes an x-ray. This may show if and where there are stones.

If stones are found, the surgeon will make a cut in the duct, remove them, and check for other stones. The surgeon will then insert a tube into the duct and bring the other end out through the skin so the bile can drain into a bag. The surgeon may inject more dye through the tube into the duct and take an x-ray to see if it is clear. If it is, the tube will be removed.

What happens after the procedure?

You may be sore for a few days. You will have intravenous fluids during the first couple of days because your intestines will be slow to start working again. If you have a tube draining your common bile duct, you may stay in the hospital for 1 to 4 days. This tube may stay in place for 7 days or as long as several weeks. Follow your health care provider's instructions for gradually resuming your normal diet.

Avoid strenuous activity, such as lifting, for 4 to 6 weeks.

Ask your health care provider when you should come back for a checkup.

What are the benefits of this procedure?

If stones were removed, you will no longer have the discomfort of a blocked duct. You will have less chance of getting jaundice and infection.

What are the risks associated with this procedure?

• There are some risks when you have general anesthesia. Discuss these risks with your health care provider.
• Swelling or scarring may damage the duct.
• Bile may leak from the duct.
• The surgeon may have to open your small intestine.
• You may develop an infection, and if the surgeon has to reopen the cut and insert a tube to allow the infection to drain, it may take longer to heal.
• Bleeding may occur.

You should ask your health care provider how these risks apply to you.

When should I call my health care provider?

After you have gone home from the hospital, call your provider right away if:

• You have abdominal pain.
• Your wound becomes red, warm, or very sore or starts to drain fluid.
• You develop nausea and vomiting.
• You develop a fever.

Call your provider during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.