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Stone in CBD
Discussion in 'All Categories' started by Aarav - Jan 1st, 2024 11:56 am.
I have 8 mm stone in CBD. What are the available treatment options for a stone in the CBD?
re: Stone in CBD by Dr. B. S. Bhalla - Jan 1st, 2024 12:21 pm
Dr. B. S. Bhalla
Dr. B. S. Bhalla
I can provide some general information about potential treatment options for a common bile duct (CBD) stone.

Observation: Small stones may pass through the common bile duct on their own without causing significant issues. Your doctor may choose to monitor the stone's progress through regular imaging and manage any symptoms.

Medication: In some cases, medications such as ursodeoxycholic acid (UDCA) may be prescribed to dissolve cholesterol stones. However, this approach is often less effective for larger stones and may take a long time.

Endoscopic Retrograde Cholangiopancreatography (ERCP): This procedure involves the insertion of a flexible tube (endoscope) through the mouth, esophagus, and stomach into the duodenum. Contrast dye is injected, and X-rays are taken to locate and remove the stone. In some cases, a sphincterotomy (cutting the muscle around the opening of the bile duct) may be performed to facilitate stone removal.

Percutaneous Transhepatic Cholangiography (PTC): This procedure involves the insertion of a thin needle through the skin and into the liver to inject contrast dye into the bile ducts. X-rays are then taken to locate and remove the stone.

Laparoscopic or Open Surgery: Surgical removal of the stone may be considered in certain cases, particularly if other methods are not suitable or successful. This can involve either laparoscopic (minimally invasive) or open surgery.
re: Stone in CBD by Dr. Suresh Karki - Jan 4th, 2024 10:16 am
Dr. Suresh Karki
Dr. Suresh Karki
Having an 8 mm stone in the Common Bile Duct (CBD) can be a challenging situation, and it's essential to explore appropriate treatment options. Here's an overview of potential treatment options:

Observation: For small stones that are not causing symptoms, a watch-and-wait approach may be considered. Regular monitoring and lifestyle modifications, such as dietary changes, might be recommended.

Endoscopic Retrograde Cholangiopancreatography (ERCP): This procedure involves the insertion of an endoscope through the mouth and into the small intestine to remove or break down the stone. ERCP can be effective for stones in the CBD.

Laparoscopic Surgery: In some cases, minimally invasive surgery may be recommended to remove the stone. Laparoscopic common bile duct exploration (LCBDE) is a surgical option.

Cholecystectomy: If the stone is associated with gallstones, your doctor may recommend the removal of the gallbladder (cholecystectomy) to prevent further stones from forming and migrating to the CBD.

Extracorporeal Shock Wave Litho tripsy (ESWL): This non-invasive procedure uses shock waves to break down the stone into smaller fragments, making it easier for the body to pass or for further interventions.

Dissolution Therapy: For specific types of stones, medications may be prescribed to dissolve the stones. This approach is less common and depends on the composition of the stone.

Stent Placement: Temporary or permanent stent placement might be considered to keep the CBD open and facilitate the passage of bile and stones.

The choice of treatment depends on factors such as the size and type of the stone, associated symptoms, and overall health.
re: Stone in CBD by Siddharth - Feb 3rd, 2024 10:16 am
I have stone in CBD. Are there any potential complications associated with the stone in the CBD?
re: Stone in CBD by Dr. Bishal - Feb 3rd, 2024 10:24 am
Dr. Bishal
Dr. Bishal
The common bile duct is a tube that carries bile from the liver and gallbladder to the small intestine, and a stone in this duct can lead to various complications. Common bile duct stones can cause:

Obstruction: A stone in the CBD can block the flow of bile, leading to an obstruction. This can result in symptoms such as jaundice (yellowing of the skin and eyes), dark urine, pale stools, and abdominal pain.

Inflammation: The presence of a stone can cause inflammation in the duct, a condition known as cholangitis. Symptoms may include fever, chills, abdominal pain, and jaundice.

Pancreatitis: If a stone blocks the pancreatic duct, it can lead to inflammation of the pancreas, known as pancreatitis. This can cause severe abdominal pain, nausea, and vomiting.

Infection: Bile duct stones can increase the risk of bacterial infection in the bile duct, leading to cholangitis. Infections can be serious and may require prompt medical attention.

Complications during surgery: If the stone requires surgical removal, there can be risks associated with the procedure, including bleeding, infection, or injury to nearby structures.
re: Stone in CBD by Prabhunath - Jun 3rd, 2024 12:26 pm
Having CBD stone. If surgery is needed, what type of surgery do you recommend (e.g., ERCP, laparoscopic cholecystectomy)?
re: Stone in CBD by Dr. Rishi - Jun 3rd, 2024 12:27 pm
Dr. Rishi
Dr. Rishi
For managing a common bile duct (CBD) stone, several surgical options are available, and the choice depends on various factors, including the size and location of the stone, the patient's overall health, and any underlying conditions. Here are the common surgical options:

Endoscopic Retrograde Cholangiopancreatography (ERCP):

Procedure: A specialized endoscope is passed through the mouth, stomach, and into the duodenum to access the bile ducts. Stones can be removed or fragmented.

Advantages: Minimally invasive, avoids the need for open surgery, can be performed as a day procedure, and can also be diagnostic and therapeutic.

Considerations: Usually preferred as the first line of treatment for CBD stones.

Laparoscopic Cholecystectomy:

Procedure: Minimally invasive surgery to remove the gallbladder. If stones are present in the CBD, they can be removed during the procedure.

Advantages: Minimally invasive, shorter recovery time, less postoperative pain compared to open surgery.

Considerations: Often used if the stones are in both the gallbladder and the CBD, or if ERCP is not successful or not possible.

Open Cholecystectomy with CBD Exploration:

Procedure: Traditional open surgery to remove the gallbladder and explore the CBD to remove stones.
Advantages: Allows direct visualization and access to the biliary tree.

Considerations: More invasive, longer recovery time, typically reserved for complicated cases or when laparoscopic methods are not feasible.

Percutaneous Transhepatic Cholangiography (PTC):

Procedure: Involves inserting a needle through the skin into the liver to access the bile ducts for stone removal or drainage.

Advantages: Useful for patients who are not candidates for ERCP or laparoscopic surgery.

Considerations: Typically used in complex cases or when endoscopic methods are not successful.


First-Line Treatment: ERCP is generally the first choice for removing CBD stones because it is minimally invasive and highly effective.

Follow-Up with Cholecystectomy: If you have stones in the gallbladder or recurrent CBD stones, a laparoscopic cholecystectomy may be recommended to prevent future issues.
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