Common bile duct stones are present in 10-20% of patients with symptomatic gall stones.
Most commonly results when stone slips from the gall bladder into the CBD. However, there are few cases when stones are primarily formed in the common bile duct.
When stones are present in cbd, it can cause biliary obstruction leading to jaundice, cholangitis or infection resulting in fever, pain and jaundice or pancreatitis if it blocks the pancreatic duct.
Presence of stones in common bile duct requires immediate treatment. Broadly, it can be dealt in 2 ways:
ERCP: With the advent of Endoscopic retrograde cholangio pancreatography (ERCP), majority of the stones present in common bile duct can be removed by this method. The procedure is usually performed as a day care procedure and the stones are removed using a endoscope.Although the success rate for stone clearance in isolated ERCP treatment is up to 87% to 97%, up to 15% of patients require two or more ERCP treatment .
Laparoscopic Common Bile Duct Exploration: In experienced hands, the laparoscopic common bile duct exploration is a potential option for managing stones within the biliary tree at the same time as laparoscopic surgery for the gall stones.With advancing technology and minimally invasive surgery, laparoscopic biliary surgery has become safe, efficient, and cost effective.We perform laparoscopic CBD exploration in patients who have failed ERCP, or in patients having very large stones or when the stones are detected during laparoscopic cholecystectomy. we remove the CBD stones through the same small holes used for removal of gall bladder and gall bladder stones.