A Study of Clinical Outcome in 30 Patients of Common Bile Duct Stone

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 clinical outcome for CBDstone and evaluate the treatment modality.Material and Methods: This retrospective study was done in30 cases of Common bile duct stone for period of 1 year. All 30patients included in the study were appropriately investigatedby laboratory investigations, USG, CT scan and MRCP.Results: Out of 30 patients included in the study, 26 hadundergone successful ERCP and had successful clearance ofCBD which were followed by Laparoscopic cholecystectomy.2 patients had failed ERCP clearance, out of which 1 patienthad undergone re-ERCP with successful clearance of the stone.The other 1 patient had to undergo Open CBD explorationfollowed by cholecystectomy. 2 patients with CBD stonegreater than 2 cm had to undergo direct CBD explorationwithout undergoing ERCPConclusion: Appropriate identification of CBD stone size,location, number and CBD diameter associated with featuresof cholangitis, jaundice and pancreatitis is essential. It isa complicated procedure requiring a step-wise strategicapproach. The gold standard for the removal of CBD stoneis ERCP followed by laparoscopic cholecystectomy.Commonbile duct exploration is considered in patients with failedclearance of CBD following ERCP OR CBD stone size > 2cm.