Common bile duct stones are also called as choledocholithiasis. These stones are present in the common bile duct. The condition will lead to the liver cell damage and jaundice, so the candidates, who suffer from this conditions, should get the treatment of ERCP(Endoscopic Retrograde Cholaniopancreatography) or cholecystectomy or combined. So, the condition can be treated by an open surgery, percutaneous, laparoscopic or endoscopic ways.
Signs and Symptoms
- Negative of Murphy’s sign
- Jaundice of the eye or skin
- Jaundice with clay colored stool
- Ascending cholangitis
Most of the stones, which are in small size can pass through the CBD or common bile duct, but the larger stones are difficult to pass through the CBD and when it occurs, an obstruction is occurred. And the risk factor for this condition is the duodenal diverticulum.
The obstruction will result in the jaundice, increase of the blood cholesterol and increase of blood conjugated bilirubin. The cause will lead to the ascending cholangitis and acute pancreatitis.
Murphy’s sign is checked and it gets negative, when done as physical examination. So, it helps to confirm the cholelithiasis diagnosis confirmation. This examination is needed to differentiate choledocholithiasis and cholecystitis. Billiary obstruction can be physically found as jaundice of eye or jaundice of the skin. Other diagnosis information is that the candidate starts vomiting or nausea after taking a fatty meal.
When the CBD stones condition is prolonged, vitamin K absorption will be decreased and INR may change as the result. It means the bile flow will be decreased. Such diagnosis can be done using MRCP or Magnetic Resonance Cholangiopancreatography.
Common Bile duct Stones Surgery
ERCP can be chosen by the surgeon, as a potential treatment option. ERCP has a benefit that not only the treatment, but also diagnosis can done through the procedure. ERCP procedure involves to widen the bile duct opening and through the opening, the removal of the stones. Endoscopic is the invasive way of procedure to perform the operation. So there will be potential complications seen after the operation.
The removal of stones from CBD is increasingly performed using the laparoscopy, by the surgeons. Since it is minimally invasive procedure, tiny or smaller incisions are to be made at the abdominal site. Then other incisions are also made at the cystic duct, which connect the bile duct to the gallbladder. A thin tube is passed through the incision so that the cholangiography is performed. When the camera captures the images of the stones, the surgeon starts inserting another tube that contains an inflatable balloon so that the duct could be widened. Then the stones are removed through a tiny basket or balloon.
Most of the time, the stones in CBD will be removed through laparoscopy. However, sometimes, there might be some stones left in their places. In such conditions, an open choledocholithotomy has to be performed. For larger stones that cannot be removed from the laparoscopy, this procedure is usually used. Other conditions can be complex duct anatomy, followed or during the operations of the gallbladder, at the time of detecting the stones. Open choledocholithotomy is also performed when laparoscopic or ERCP procedures are not available. This procedure involves removal of the gallbladder and then cholecystectomy operation is performed so that the future occurrence obstruction at common bile duct or similar other complications can be prevented.
Cost of Common Bile duct Stones Surgery
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