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Research Paper | Surgery | India | Volume 12 Issue 1, January 2023 | Rating: 5.2 / 10
Various Surgical Management of Post-ERCP Retained CBD Stones
Dr. P. Thangamani M.S. | Dr. K. Senthil Kumar M.S. | Dr. K. Sudar M.S.
Abstract: Introduction: The presence of a stone or stones within the common bile duct (CBD) is known as choledocholithiasis. The incidence of choledocholithiasis in <60 years of age is 8-15% when compared with 15-60% in >60 years of age. ERCP remains the first line of management for CBD stones followed by Lap cholecystectomy. But ?difficult CBD stones? may get retained following single or multiple sessions of ERCP due to the impaction of large stones or because of their location above the stricture of the duct. In our institution, open CBD exploration along with primary closure or choledochoenterostomies or T-tube drainage is done for ERCP failed CBD stones. Objectives: 1) To study the outcome, morbidity and mortality of surgical management of post ERCP CBD stones. 2) To study the factors predisposing to failure of ERCP stone removal. Materials and Methods: This is a prospective and a retrospective observational study of patients admitted with common bile duct stones in Institute of General surgery, RGGGH. Patients were subjected for ERCP initially and in those with post ERCP retained CBD stones, open or laparoscopic CBD exploration were done depending upon the need and or the indications. All patients were monitored closely for post-surgical complications. Results: Large, impacted stone was the most common factor causing ERCP failure. Multiple, large (1.5-2cms), distal CBD stones were the most common to get retained post ERCP stenting. Upon comparing primary closure with T-tube drainage during OCBDE, there was a significant correlation between the primary closure and shorter operative time and hospital stays with comparable complication rates.
Keywords: Post ERCP stenting, CBD stones, T tube, Primary closure of CBD, CDJ
Edition: Volume 12 Issue 1, January 2023,
Pages: 91 - 94