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cbd stone in hindi

The incidence of gallstones is very common and varies from 6 % to 10 % in adult population. Their treatment involves surgeons, endoscopists and anaesthesiologists depending on clinical presentation. The “gold standard” treatment for cholecystolithiasis is laparoscopic cholecystectomy (LC), whereas the “gold standard” treatment for isolated common bile duct (CBD) stones, especially in cholecystectomized patients, is endoscopic clearance [1]. On the contrary, when gallstones and CBD stones are present concurrently, the treatment is a challenge. A consensus on optimal management does not exist. Several approaches are used, all having their proponents, such as open surgery, laparoscopy, and laparoendoscopic treatments, either sequential or simultaneous.

Introduction

Decision making is easier when stones are discovered intraoperatively. The availed options are; (a) total laparoscopic clearance, (b) combined laparoendoscopic treatment, (c) conversion to open CBD exploration, and (d) post cholecystectomy ERCP.

Stones Discovered Intraoperatively

It is desirable that all those and only those patients with choledocholithiasis should undergo CBD exploration at cholecystectomy. CBD should be imaged if there is intraoperative doubt about choledocholithiasis. This can be achieved by radiographic intraoperative cholangiography (IOC) via the transcystic approach or intracorporeal laparoscopic ultrasonography (LUS). In experienced hands, LUS seems to be as accurate as cholangiography for diagnosis of choledocholithiasis, but can be performed more rapidly. Li et al. in 2009 have shown that LUS is more sensitive than IOC for detecting stones but IOC is better for delineating the anatomy. Both these techniques should be viewed as complementary method to maximise the intraoperative detection of occult CBD stones [12].

Cbd stone in hindi

Portincasa P, Moschetta A, Palasciano G. Cholesterol gallstone disease. Lancet. 2006 Jul 15. 368(9531):230-9. [Medline].

Related Questions:

Williams TP, Dimou FM, Adhikari D, Kimbrough TD, Riall TS. Hospital readmission after emergency room visit for cholelithiasis. J Surg Res. 2015 Aug. 197(2):318-23. [Medline].

References

Nagem RG, Lazaro-da-Silva A, de Oliveira RM, Morato VG. Gallstone-related complications after Roux-en-Y gastric bypass: a prospective study. Hepatobiliary Pancreat Dis Int. 2012 Dec 15. 11(6):630-5. [Medline].