Retrospective Study of Clinical Outcome in 25 Patients of Common Bile Duct Calculi

ABSTRACT

Introduction: Management of common bile duct stones(CBDS) presents a surgical challenge since it is the majorcause of hepatobiliary morbidity and complications. The aimof the study was to evaluate the best line of treatment for CBDstone and complications related to every approach.Material and Methods: This retrospective study includespatients with CBDS who were treated with conservativetreatment or endoscopic stone extraction followed bylaparoscopic cholecystectomy (LC). Primary outcome wassuccessful clearance of common bile duct and secondaryoutcomes were complications, total cost and hospital stay.Results: Out of 25 patients, 13 were treated by ERCP(Endoscopic Retrograde Cholangio Pancreatography) and12 by Conservative approach. There was complete clearanceof CBDS in 10 (76%) cases out of 13, in the endoscopicretrograde cholangiopancreatography (ERCP) group and inthe remaining 3 patients, the Common bile duct stone wasremoved by the trans-cystic exploration. In the conservativegroup, there was complete clearance of CBDS in 8 (66%)cases, and in the remaining 4 (33%)patients, the common bileduct stone was removed by the transcystic exploration.Conclusion: Management of CBDS represents a surgicalchallenge. CBDS increases the technical difficulty of ERCPand increases the risk of PEP. Conservative managementof CBDS avoids the risks associated with ERCP and isalso effective in clearing CBDS so one should consider aconservative line of treatment in CBDS in order to decreasethe cost and avoid unnecessary ERCP.