Question about choledocolithiasis and gallstone pancreatitis

[nafraguoc]

MS3 here in the middle of surgery rotation. We had a spontaneous teaching session on gallstone associated diseases with my resident yesterday and it sparked a question about when a stone would cause choledocolithiasis and when it would cause pancreatitis.

Both are caused by obstruction at the sphincter of Oddi, but why would it sometimes lead to inflammation of the bile duct, and other times cause pancreatits. Why not both or neither? Any thoughts?

---

Members don't see this ad.

 

[Gator7]

Choledocholithiasis is caused by a stone in the common bile duct, not necessarily just at the sphincter. Pancreatitis is caused when the stone is at the level of the main pancreatic duct and impedes the flow of pancreatic secretions.

 

[ACSurgeon]

In addition to the above: most stones pass spontaneously. Whether or not a stone in the CBD leads to other complications like pancratitis or cholangitis depends on the duration of the obstruction and patient factors that make hem higher risk for these diseases.