MANAGEMENT OF COMMON BILE DUCT STONES AT A TERTIARY CARE HOSPITAL
Background. Common Bile Duct stones are traditionally treated with open cholecystectomy combined with CBD exploration and T-Tube drainage. With advances in endoscopy and laparoscopy, now other options are available. Methods 52 cases of CBD stones presenting to a tertiary care hospital in outskirts of Delhi were analysed for presentation and management procedures and outcome Results 17 patients underwent ERCP with stone retrieval and CBD stenting followed by Laparoscopic Cholecystectomy. ERCP failed in 4 patients and they were managed by open CBD exploration. 31 patients refused ERCP because of higher cost and were directly managed with open CBD exploration. One patient underwent sphinteroplasty and 5 patients needed biliary enteric anastomosis because stones could not be removed. CBD exploration and T-tube drainage was done in 21 cases and primary closure in 8 cases. Ureteroscope was used to assist stone removal and ensure clearance. Conclusion Various options are available for CBD stones like ERCP, Laparoscopic CBD exploration and Open CBD exploration. Open CBD Exploration with use of ureteroscope for ensuring CBD clearance and primary closure of CBD offers a single stage, cost effective procedure.
CBD Stones, ERCP with CBD Stenting, Laparoscopic CBD Exploration, Open CBD Exploration, Primary Closure of CBD.