Common Bile Duct Stones

Unlike the situation with gallbladder stones where surgery is recommended only when a person has symptoms, for stones in the common bile duct, treatment is highly recommended even if the person claims he has no symptoms. This is because of the potential dire consequences of common bile duct stones.

There are 2 main options for the removal of common bile duct stones.

1. Laparoscopic Common Bile Duct Exploration (LCBDE)

LCBDE is one of the techniques to surgically remove common bile duct stones. The gallbladder is usually removed at the same time, since most of the bile duct stones originate from the gallbladder. It is a surgical operation performed through small incisions. Typically, 4 small incisions are needed.

2. ERCP Followed by Laparoscopic Cholecystectomy

ERCP is a special endoscopic procedure which allows the doctor to remove bile duct stones. In this method, there are 2 steps to it

Step 1

The patient will have to undergo an endoscopy called an ERCP, during which the endoscopist will widen the bile duct opening in the small intestine (sphincterotomy). The endoscopist will then attempt to remove the stone in the bile duct.

Step 2

If step 1 is successful, the patient then proceeds to step 2 to remove the gallbladder. This is usually done by the keyhole technique called the laparoscopic cholecystectomy.

Step 1 and 2 are usually performed on different days. Hence, the disadvantages of this method of treating bile duct stones are

– 2 separate procedures, each with its own risks

– 2 separate days, hence the treatment period may be prolonged.