Non invasive treatment of common bile duct obstrucion

ABSTRACT

The study comprises 28 patients with obstruction of the common bile duct [CBD]. Twenty patients with calcular obstruction, these included 5 patients with missed stones in the CBD following cholecystectomy, 4 patients with malignant obstructive janudice and 4 patients with benign stricture of the CBD. All patients were subjected to full clinical examination and basic investigations, and liver function tests. Serum bilirubin and alkaline phosphatase were elevated in all patients. Abdominal ultrasonography was done and diagnostic endoscopic retrograde cholangiopancreatography with side viewing endoscopy was done to all patients. By the use of the endoscopic retrograde cholangiopancreatography, the cases of calcular obstruction of CBD were extracted by papillotomy and dormia basket or with a balloon. This procedure was successful in 17 patients out of 20. In cases presenting with stricture of the CBD failure of cannulation occured in 3 patients out of 8 and in the remaining 5 patients papillotomy with fixation of endoprosthesis was performed. All failures were surgically treated. Short and long term follow up showed satisfactory results as assessed by clinical and biochemical means