What are the clinical features of choledocholithiasis?

Acute obstruction causes biliary pain and jaundice, gradual obstruction causes pruritis and jaundice alone w/out pain. If bacteria enter, we might see cholangitis, long standing obstruction can cause secondary biliary cirrhosis, thus chronic liver disease. Serum bilirubin 2-5 mg/dl, rarely exceed 12mg/dl. Transient spikes of ALT/amylase suggest bile stone went to duodenum, liver biochemical tests sensitivity is 94% to detect choledocholithiasis.