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Biliary calculus
Other Resources UpToDate PubMed

Biliary calculus

Contributors: Michael W. Winter MD, Nishant H. Patel MD, Desiree Rivera-Nieves MD, Khaled Bittar MD
Other Resources UpToDate PubMed


Hardened crystal deposits formed from bile pigments, cholesterol, and calcium salts found in the bile duct (choledocholithiasis) or gallbladder (cholecystolithiasis). Commonly called gallstones, they are characterized by severe right upper quadrant abdominal pain or epigastric pain due to transient obstruction of the biliary tract. Other symptoms include nausea, vomiting, hyperbilirubinemia, and elevated alkaline phosphatase and gamma-glutamyl transpeptidase. Gallstones most typically occur in females in the fourth decade of life. They are increased during pregnancy, although they are relatively common and can occur in patients of all ages and across many demographics.

Treatment depends on size, location, and symptoms. Gallstones may end up in the duodenum or pylorus, which may result in gastric outlet obstruction (Bouveret syndrome). Common treatments are stone removal by endoscopic retrograde cholangiopancreatography, sphincterotomy, biliary stenting, and cholecystectomy. Goals of therapy are to prevent recurrent episodes of biliary colic and lower the risk of developing choledocholithiasis, cholangitis, and gallstone pancreatitis.


K80.20 – Calculus of gallbladder without cholecystitis without obstruction

266474003 – Calculus in biliary tract

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Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Updated:05/18/2020
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Patient Information for Biliary calculus
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Contributors: Medical staff writer


Biliary calculus is commonly known as gallstones. Gallstones are hard, crystal-like particles formed from bile fluids, cholesterol, and calcium. They can form in the gallbladder or bile duct.

Biliary calculus may not have any symptoms, or it may create intense pain. There may be other symptoms. Biliary colic (gallbladder attack) refers to severe pain caused by bile duct blockage.

Who’s At Risk

The exact cause of gallstones is uncertain. Many factors can contribute to their formation. Anyone can develop gallstones, but those most at risk are women over age 40. Gallstone formation may also run in the family. Other risk factors include:
  • Taking certain medications (such as birth control pills)
  • Some diseases (diabetes, sickle cell, cirrhosis)
  • Obesity
  • Pregnancy
  • Being inactive
Additionally, people who fast to lose weight quickly, or who have had weight-loss surgery, have a greater chance of developing gallstones.

Signs & Symptoms

Many people with gallstones have no symptoms. However, you may have right upper abdominal pain (near the stomach), nausea, and vomiting. You may even experience pain in the right shoulder or back.

Self-Care Guidelines

Maintaining a healthy weight, increasing physical activity, and enjoying a healthy diet can help prevent gallstones and their complications.

Rapid weight loss should be avoided as it may increase your chances of getting gallstones. A healthy lifestyle can also help prevent recurrence of gallstones.

When to Seek Medical Care

If you have symptoms of gallstones such as severe abdominal or epigastric pain (near stomach), nausea, and vomiting, contact your health care provider.

If you develop symptoms of gallstone complications such as yellowish skin and eyes or unrelenting severe abdominal pain, get medical help immediately.


Your doctor will discuss treatment options with you, including medication, dissolving or destroying the gallstones, and surgery (gallbladder removal or gallstone removal). The choice of best treatment depends on the size and placement of gallstones, the severity of your symptoms, and the risk of complications. Ask your doctor about the advantages and disadvantages of each treatment.
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Biliary calculus
A medical illustration showing key findings of Biliary calculus : Alkaline phosphatase elevated, Epigastric pain, Hyperbilirubinemia, RUQ pain
Imaging Studies image of Biliary calculus - imageId=7878647. Click to open in gallery.  caption: '<span>Ultrasound of the right upper  quadrant demonstrating echogenic foci with shadowing in the gallbladder  consistent with cholelithiasis.</span>'
Ultrasound of the right upper quadrant demonstrating echogenic foci with shadowing in the gallbladder consistent with cholelithiasis.
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