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The common bile duct carries bile from the liver and gallbladder to the small intestine. It is joined by the pancreatic duct and regulated by the sphincter of Oddi. Blockages can cause jaundice and require surgery or ERCP to remove stones.
The common bile duct (CBD) is an important part of the gastrointestinal tract responsible for carrying bile from the liver and gallbladder down to the duodenum, the first section of the small intestine. The duct indicates a tubular structure originating from an organ of the body, which usually carries fluids. From the liver, two hepatic ducts join to form a common hepatic duct, and from the gallbladder comes the cystic duct. At the junction where the common hepatic duct and the cystic duct join is the beginning of the common bile duct. This bile duct is longer in length and wider in diameter than the other ducts.
The end of the common bile duct is joined by the pancreatic duct from the pancreas before they open into the duodenum. There is a ring muscle called the sphincter of Oddi around the end of the CBD. It works to regulate the flow of bile and pancreatic juice into the duodenum and prevents the flow of duodenal contents into the duct.
Bile is formed in the liver and is essential in the digestion of fats and for carrying waste products from the liver to be excreted from the body. Some of the bile is stored in the gallbladder to be released for breaking down fat, usually after eating. From the liver and gallbladder, bile descends into the common bile duct to drain into the duodenum, where fat digestion can take place. Waste products carried by the bile are also sent to the duodenum, to be expelled from the body through defecation. It is the presence of bile that makes the stool color brown.
Stones from the gallbladder can pass into CBD in a condition called common choledocholithiasis and can cause obstruction if they can’t pass through the sphincter of Oddi. As the blockage progresses, the duct dilates. Symptoms of CBD blockage include jaundice or yellowing of the skin and eyes, pain in the upper right side of the abdomen, nausea and vomiting. An ultrasound is usually done to evaluate the area for the presence of stones. Risk factors for gallstone formation include obesity, genetic predisposition, and a high-fat diet.
Because a blockage causes bile to pool, bacteria can contaminate the area and multiply, and can sometimes reach the bloodstream. If this occurs, it can be life-threatening. Treatment for CBD blockage usually includes surgery or endoscopic retrograde cholangiopancreatogram (ERCP) to remove stones. Administration of antibiotics is often performed if the infection has developed.
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