-
CBD Stone / Choledocolithiasis
Introduction
Common Bile Duct (CBD) is a tube that carries bile from
gallbladder or liver to the small intestine. CBD stone also known
as duct stone or choledocolithiasis is a presence of a gallstone in
the common bile duct. Gallstone usually forms inside the
gallbladder which is a pear shaped organ below the liver. These
stone usually remains in gallbladder however sometime it migrates
into common bile duct and gets tucked obstructing the passage this
condition is called choledocolithiasis or CBD stone.
Signs & Symptoms
CBD stones may not have any signs & symptoms for months or
even years. However, if the blockage becomes severe, the following
signs & symptoms may be experienced:
Pain in the upper or middle part of abdomen Fever Jaundice Loss
of appetite Nausea & vomiting
Causes
Gallstone may develop when there is too much cholesterol or
bilirubin inside gallbladder secreted by the liver.
Too much cholesterol: Bile usually dissolves or break down
cholesterol however if the liver produces more cholesterols than
the bile can dissolve it results in formation of hard stones called
cholesterol gall stones.
Too much Bilirubin: Bilirubin is a chemical that is produced
when the body breaks down old red blood cells. In some cases such
as cirrhosis of the liver and certain blood disorders the liver
produces too much bilirubin which contributes to the gallstone
formation.
Poor emptying of Gallbladder: If the gallbladder often fails to
get empty completely the bile may becomes overly concentrated
leading to formation of gallstones.
Dr. Sanjiv Haribhakti Gisurgery.info
-
Risk Factors
Following are the risk factors of developing CBD stone:
Obesity Prolonged fasting Rapid weight loss Lethargic lifestyle
Pregnancy Age & Gender: older people and women are more likely
to have CBD stone Family history of gallbladder disease
Complications
Acute Cholangitis: CBD stone can cause infection in the bile.
The bacteria from the infection can spread rapidly. It can move
into the liver or ductal system. It can become a life threatening
infection Hepatic Abscess Billiary cirrhosis Pancreatitis
Diagnosis
Abdominal CT Scan: it is a digital imaging test that takes
pictures of the liver and abdominal region revealing the presence
of gallstone if any.
Ultrasound: this test uses ultrasonic sound waves to create
image of abdominal organs which help find presence of any
gallstone.
Endoscopic Ultrasound (EUS): an ultrasound probe is inserted on
a flexible endoscopic tube and inserted through mouth to examine
the digestive tract.Endoscopic Retrograde Cholangiography (ERCP):
it is a procedure used to identify stones, tumors and narrowing in
the bile ducts. An endoscopic tube is inserted through the mouth
and dye is injected into the ducts where they can be visualized
with x rays.
Magnetic Resonance Imaging (MRI): MRI scans of the gallbladder,
bile ducts and pancreatic duct called Magnetic Resonance
Cholangiopancreatography (MRCP).
Blood tests: to look for amount of bilirubin in the blood and to
determine the functioning of liver.
Treatment
The treatment of CBD stone includes one or more of
following:
Stone extraction
Dr. Sanjiv Haribhakti Gisurgery.info
-
Lithotripsy: breaking the stone into small pieces allowing them
to pass through Cholecystectomy: surgery to remove gallbladder and
stone Sphincterotomy: surgery to make a cut into the common bile
duct to remove stones or help them pass Biliary stenting
Laparoscopic CBD exploration Endoscopic Sphincterotomy is the most
common treatment of CBD stone.
During this procedure a balloon or basket type device is
inserted into the bile duct and used to extract the stones.
Lifestyle changes such as physical activity and dietary changes
such as increasing fiber and decreasing saturated fats can reduces
the chances of developing CBD stones.
Dr. Sanjiv Haribhakti Gisurgery.info
