Investigations

The preferred investigations in choledocholiathiasis are:

• ultrasound:
  • it may show a dilated biliary system
  • stones are more difficult to see
• ERCP:
  • this is used to demonstrate stones in the ducts
  • PTC is a secondary way of showing stones
• full blood count - shows a leukocytosis
• liver function tests:
  • show an increase in bilirubin, alkaline phosphatase and gamma GT
  • there may be a mild increase in transaminases
• prolonged prothrombin time
• abdominal radiology may reveal air in the biliary tree