A CLINICAL STUDY AND MANAGEMENT OF COMMON BILE DUCT STONES

There are three goals for treating people with gallstone disease who may have stones in the common bile duct; to assess the probability of bile duct stones, to treat those stones if they are present & to remove the stone. As a result, the current study focuses on the various modes of presentation of CBD stones as well as the clinical outcomes of various choledocholithiasis treatment modalities such as pre-operative ERCPand LFT. The present study was a prospective clinical observational study carried out at Department of General Surgery, Smt. Kashibai Navale Medical College and General Hospital over a period of 24 months from 2020 to 2023. Total 50 patients were enrolled in this study. Age incidence varies between 35 and >65 years, and the mean age of incidence is 50 years. The most patients had CBD diameter either between 4.1 to 5 mm. 7 (14%) patients had clinical evidence of jaundice (icterus) because their total bilirubin values were near 1 mg%. Most of the patients had values between 0.4 to 0.7 mg%. Most common organism isolated was E. Faecalis 15 (30%) cases. 12 patients (24%) had no evidence of any growth despite of culturing for 48 hrs on both aerobic and anaerobic culture media. . MRCPwas used in 50 cases with negative USG for CBD stones and had specicity of 100% in this study. Out 0f the 50, 24 showed the positive results. ERCP had success of clearing the CBD of all the stones in 25 % of the cases. 23 patients (46%) developed infection of surgical wound as a result of contamination from the biliary tract. Bile leak was seen in 26 patient (52%). From the study ndings we conclude that, there can be no denite algorithm for the management of CBD stones as the patients' age, underlying general condition being the only standardizable factor with facilities for endoscopic management being variably available from institution to institution and hence, necessitating tailoring the management of CBD stones depending upon the Institution's resources.