Evaluation In The Management of Cholidochlithiasis (Common Bile duct stones)

Common bile duct (CBD) stones affects around 5-15% of patient with gallbladder stones. Mainly it comes from gall bladder, but occasionally it can develop in the CBD itself. Patients will develop serious complications like acute pancreatitis, cholangitis, obstructive jaundice and secondary biliary cirrhosis. It is essential to exclude or confirm the CBD stones in patient with gall stones disease. Serum bilirubin and alkaline phosphatase levels and trans abdominal ultrasound scans were the basic investigation tools. With the technological development Magnetic resonance imaging MRI and laparoscopic ultrasound scan play important roles in the investigation of CBD stones. At the same times ERCP develops as a main diagnostic and therapeutic tool in the management of the CBD stones. After the introduction of the laparoscopy in the field of surgery it starts to contribute much in the management of biliary stones as well. Laparoscopic approach changes the two stage procedure of the gall stones disease as cholecystectomy and pre or post cholecystectomy ERCP in to single stage procedure. Aim of this article is to discuss the changes happen over the past few decades in the management of CBD stones and how and why it occurred.