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Spontaneous passage of common bile duct stones in jaundiced patients |
Valentina Lefemine and Richard John Morgan |
Rhyl, UK
Author Affiliations: Department of General Surgery, Glan Clwyd Hospital, Rhyl, UK (Lefemine V and Morgan RJ)
Corresponding Author: Richard John Morgan, MD, Department of General Surgery, Glan Clwyd Hospital, Rhyl, LL18 5UJ, UK (Tel: 01745-534334; Fax: 01745-534688; Email: richard.morgan@wales.nhs.uk) |
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Abstract BACKGROUND: Common bile duct (CBD) stones are known to pass spontaneously in a significant number of patients. This study investigated the rate of spontaneous CBD stones passage in a series of patients presenting with jaundice due to gallstones. The patients were managed surgically, allowing CBD intervention to be avoided in the event of spontaneous passage of CBD stones.
METHOD: Retrospective analysis of patients presenting with jaundice due to CBD stones, and managed surgically with laparoscopic cholecystectomy and intra-operative cholangiogram with or without CBD exploration.
RESULTS: The jaundice settled pre-operatively in 76/108 patients, and in 60/108 the CBD stones had passed spontaneously by the time of surgery. These 60 patients avoided any intervention to their CBD.
CONCLUSIONS: CBD stones pass spontaneously in more than half of jaundiced patients. Surgical management (laparoscopic cholecystectomy and intra-operative cholangiogram, with willingness to perform CBD exploration if positive) allows the avoidance of CBD intervention in these patients.
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