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Choledocholithiasis
Choledocholithiasis occurs when gallstones migrate into the common bile duct, causing pain, jaundice, and infection risk. At GastroDoxs in Houston, Dr. Nghia Nguyen offers personalized diagnosis and advanced minimally invasive treatments, ensuring expert care for relief and improved digestive health.
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
Common Causes and Risk Factors
Migration of gallstones into the common bile duct
Age over 60 years
Female gender
Obesity or high cholesterol in bile
Rapid weight loss
Family history of gallstones
Signs and Symptoms
Pain in the upper right abdomen, often radiating to the back or right shoulder
Jaundice (yellowing of the skin and eyes)
Dark urine and pale, clay-colored stools
Fever or chills, suggesting cholangitis (infection)
Itchy skin due to bile salt deposition
How Dr. Nghia Nguyen Diagnoses Choledocholithiasis?
Dr. Nguyen uses a step-by-step approach:
Medical History and Physical Exam
He reviews your epigastric pain pattern, past gallbladder issues, weight changes, and family history of gallstones.
Blood Tests
He checks liver enzymes, bilirubin, alkaline phosphatase, and inflammatory markers to assess bile duct obstruction or infection.
Imaging Studies
Abdominal ultrasound to detect stones, bile duct dilation, and gallbladder status.
MRCP (Magnetic Resonance Cholangiopancreatography) for noninvasive, high-resolution imaging of bile ducts.
Endoscopic ultrasound (EUS) when further detail is needed to confirm stone presence and location.
Advanced Testing (if needed)
If noninvasive tests are inconclusive or therapeutic intervention is planned, ERCP can directly visualize, diagnose, and remove duct stones; peroral cholangioscopy may be used to break up difficult stones.
Treatment
Our Team offers a full range of care for choledocholithiasis.
1. Lifestyle and Diet Tips
Eat small, balanced meals low in fat
Stay active to help maintain a healthy weight
Drink plenty of water to keep bile flowing
2. Medications
Ursodeoxycholic acid to dissolve small bile duct stones
Pain relievers to manage discomfort until definitive treatment
3. Minimally Invasive or Advanced Procedures
ERCP (Endoscopic Retrograde Cholangiopancreatography) to remove stones from the duct
Laparoscopic cholecystectomy to remove the gallbladder if gallstones are present
Peroral cholangioscopy for direct visualization and stone fragmentation
Dr. Nghia Nguyen, DO, is a board-certified gastroenterologist providing advanced digestive care in the Greater Houston area. He earned his medical degree from the Texas College of Osteopathic Medicine and completed both his Internal Medicine residency and Gastroenterology fellowship at the University of Texas at Rio Grande Valley. Dr. Nguyen specializes in treating conditions such as acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and liver disorders.
Frequently Asked Questions
What is the ICD-10 code for choledocholithiasis?
ICD-10 codes for choledocholithiasis are in the K80.5x series, for example K80.50 when there's no associated cholangitis.
Can choledocholithiasis cause pancreatitis?
Yes. A stone can block the pancreatic duct, leading to inflammation (pancreatitis). Early removal of the stone helps prevent this.
How long does ERCP take?
An ERCP procedure typically takes 30 to 60 minutes. Most patients rest briefly afterward and can often go home the same day.
Are there risks with ERCP?
Although ERCP is generally safe, possible complications include mild pancreatitis, bleeding, or infection. Dr. Nguyen employs techniques to minimize these risks.
What are the main risk factors for choledocholithiasis?
Key risk factors include existing gallstones, age over 60, female gender, obesity, rapid weight loss, and a family history of gallstones.
Will I need my gallbladder removed?
Often, yes. A laparoscopic cholecystectomy (gallbladder removal) is recommended to prevent new stones. Dr. Nguyen will discuss your individual treatment plan.
When should I seek medical help?
If you experience sharp upper abdominal pain, jaundice (yellowing of the skin or eyes), fever, or chills, contact GastroDoxs in Houston immediately to avoid serious complications.
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