Pathogenesis and Clinical Presentation of Bile Duct Calculi

Clearer understanding of the pathogenesis of bile duct calculi and better recognition of the clinical presentation of various clinical disorders caused by biliary stones are essential for proper diagnosis and treatment. This article reviews the pathogenesis of secondary stones (cholesterol and black pigment stones) and primary stones (brown pigment stones), as well as the main features of biliary calculi (pain, obstruction, and sepsis), followed by discussion of the clinical presentations of bile duct stones with gallbladder in situ and after cholecystectomy, and description of the manifestations of primary bile duct stones, cholangitis, primary sclerosing cholangitis, oriental cholangitis, and gallstone pancreatitis.