Clinical and biochemical comparative study of different types of common bile duct stones.

ABSTRACT

BACKGROUND: The chemical composition of common bile duct (CBD) stones may have significance with regard to the origin, clinical presentation and treatment. OBJECTIVE: To study the chemical composition of CBD stones and compare different types of CBD stones. METHODS: Consecutive patients with CBD stones seen over a 1-year period were studied prospectively. Their stones were analyzed for cholesterol, bilirubin and calcium contents. RESULTS: Of 74 patients with CBD stones, 42 had associated gall bladder (GB) stones (Group 1), 14 had post-cholecystectomy CBD stones (Group 2) and 18 had CBD stones with a stoneless GB in situ (Group 3). Of the 40 patients whose CBD stones were analyzed, 34 (85%; 18/19 in Group 1, 5/6 in Group 2 and 11/15 in Group 3) had cholesterol stones; the remaining 6 patients had pigment stones. CONCLUSION: Most CBD stones in northern Indian patients are cholesterol stones. Even in patients with isolated CBD stones (with stoneless GB in situ), three-quarters are cholesterol stones.