The biliary tract starts at the hepatocyte canaliculi, which empty into biliary ductules. Larger ducts join the right and left hepatic ducts, which drain into the common hepatic duct at the porta hepatis. When the cystic duct from the gallbladder joins the common hepatic duct, the common bile duct is formed.


Acute calculous cholecystitis. Inflammation of the gallbladder is associated with gallstones in more than 90% of cases. It is a common problem, presenting as an acute abdomen, especially in middle-aged women.


Stones in the bile ducts may be primary (develop in the duct) or secondary (originate in the gallbladder). If they are discovered after cholecystectomy, they may have been overlooked (retained) or may have formed after the surgery (recurrent). Primary bile duct stones are rare in Western countries.

Gallstone Disease

Gallstone disease is a major health problem in the United States. It affects approximately 20% of adult Americans. Gallstones are formed by the precipitation of insoluble bile constituents: cholesterol, polymerized bilirubin, bile pigments, calcium salts, and proteins.