Large common bile duct stone: a case report

Choledocholithiasis, the presence of stones within the common bile duct (CBD), poses significant therapeutic challenges, especially when stones exceed 15 mm in diameter. Large CBD stones can lead to complications such as biliary obstruction, cholangitis, and pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) is the first-line treatment; however, surgical intervention may be required for refractory cases. We present a case of a 50-year-old female with a giant CBD stone measuring 6 × 4 × 4 cm, managed successfully via open CBD exploration and T-tube placement after failed endoscopic extraction. This case underscores the importance of tailored management strategies for complex biliary stone disease. While ERCP remains the gold standard, open CBD exploration remains a viable option for large, impacted stones.