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Symptoms usually start after a stone of sufficient size (larger than 8mm) blocks the cystic duct or the common bile duct. The cystic duct drains the gallbladder, and the common bile duct is the main duct draining into the duodenum. Together, these ducts form part of the biliary system.
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A stone blocking the opening from the gallbladder or cystic duct usually produces symptoms of biliary colic, which is right upper abdominal pain that feels like cramping. If the stone does not pass into the duodenum, but continues to block the cystic duct, acute cholecystitis results.
If the common bile duct is blocked for a long period of time, bacteria may grow behind the stone in the stagnant bile, producing symptoms of cholangitis. Cholangitis is a serious condition and usually requires hospitalization. Continued blockage of normal bile flow may produce jaundice (yellow skin and eyes).
Stones blocking the lower end of the common bile duct (where it enters the duodenum) may obstruct secretion from the pancreas, producing pancreatitis. This condition can also be serious and may require hospitalization.
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