© 2003 Fellowship of Postgraduate Medicine
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Treatment options for common bile duct stones
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These are summarised in fig 1
. Endoscopic extraction of common bile duct stones after spincterotomy and mechanical lithotripsy has a success rate of up to 95% and is considered the treatment of choice.1,2 The reason for failure in this case was the large size of the bile duct calculus. Other reasons include bile duct strictures, unusual anatomy, and calculi beyond reach of the wire basket.1–3
[in a new window] Figure 1 Treatment options for common bile duct stones (CBD, common bile duct; ERCP, endoscopic retrograde cholangiopancreatography; ESWL, extracorporeal shockwave lithotripsy).
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Traditionally such patients have been referred for surgical exploration of the common bile duct but this procedure is not without risk, particularly in elderly patients or those with major medical comorbidities.4
Extracorporeal shock wave lithotripsy (ESWL) was investigated initially for treatment of gallbladder stones, but a high stone recurrence rate has limited its use in this condition. 5 In recent years high energy ESWL has been
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- Treatment options for common bile duct stones
- H R Ferguson, T J Robinson
Postgrad. Med. J. 2003 79: 178.[Extract] [Full Text] [PDF]
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