Extractability of common bile duct stones at endoscopic cholangio-pancreatography: a local experience

Abstract

Background: Common bile duct stones are the treatable cause of obstructive jaundice. We aimed to determine the extractability of these at endoscopic cholangio-pancreatography in terms of size, number and location, using standard techniques.

Methods: This descriptive study was conducted at Gastroenterology Unit, Hayatabad Medical Complex Peshawar from January 1997 to August 2009. Patients with common bile duct stones were included. Olympus JF-130 side-viewing video dudenoscope with Olympus CV-160 image processor and Toshiba CS-11 fluoroscope were used. After a scout film, contrast was injected to demonstrate stones. The number, size and location in common bile duct were noted. Sphinterotomy was performed using Olympus diathermy unit. Stone removal attempted using balloon-tip catheter and/or Dormia basket.

Results: Total 170 patients with common bile duct stones were studied; 72(42%) males and 98(58%) females, mean age 48.86±13.4 years. Stone size was <1.5cm in 147(86.5%), and >1.5cm in 23(13.5%) patients. Average number of stones was 2.1, range 1-5. In 123(72.4%) patients stones were confined to distal, in 25(14.7%) to proximal duct, and in 22(12.9%) to the entire length. Stones were successfully retrieved in 147(86.5%) patients with size <1.5cm, regardless of number or location. The failure rate was 13.5% (n=23) with stone size >1.5cm.

Conclusion: Common bile duct stones <1.5cm can easily be extracted at ERCP, using standard techniques, regardless of number or location in the duct.