Whether gallstones themselves cause the cancer, or whether some factor in bile is responsible for both conditions is unknown. One study demonstrated that gallbladder removal reduced the likelihood of bile duct cancer, suggesting that gallstones themselves were responsible. Perforation and gangrene or abscess formation may occur when severe symptoms persist for many days. The risk for perforation increases with a condition called emphysematous cholecystitis, in which gas forms in the gallbladder. This condition is most common in people with diabetes.
Abdominal pain is usually severe and is typically present for more than seven days.
The physical exam is not distinctive. Both perforation and empyema require prompt surgery. The complications can be avoided, however, by seeing a physician as soon as gallbladder symptoms occur. Complications in the Common Bile Duct Gallstones occasionally lodge in the common bile duct instead of the gallbladder, a condition called choledocholithiasis. When this occurs, stones can block the flow of bile out of the liver, causing jaundice.