Gallstones are formed in the gall bladder. Sometimes, the stones can move into bile ducts and cause a number of problems. Common Bile Duct (CBD) is a pipe which carries bile from the liver into bowel. Gallbladder is formed as a branch of the bile duct.
Which scans for diagnosis?
Gall bladder stones are treated by many surgeons. However, when the stones slip out of the gall bladder and enter the CBD, surgical treatment can involve more complex surgery. While the gall bladder stones can be easily detected with an ultrasound scan, CBD stones may require more detailed scans such as an MRI or a CT scan. On occasions, although rare an endoscopic procedure called ERCP (Endoscopic Retrograde Cholangio-Pancreaticogram) may be required to determine the presence of CBD stones.
Surgery or Endoscopy?
There are two possible ways of extracting CBD stones. Endoscopically or surgically. The endoscopic procedure (ERCP) involves introducing a special flexible telescope through the throat into the duodenum (first part of small bowel). Bile ducts are accessed using special catheters and the stones are extracted after cutting the sphincter at the bottom end of the bile duct. This is the sphincter which regulates the entry of bile into the bowel and prevents any of the bowel contents going back into the bile ducts. Surgical extraction (CBD exploration) can be done laparoscopically (via key hole) at the same time of the operation to remove your gall bladder. This way, CBD stones can be extracted at the same operation of laparoscopic cholecystectomy and preserves the bile duct sphincter. Former option involves two admissions / procedures, while later can be done during one admission under one episode of general anaesthetic.
Mr Jayanthi will be able to explain to you the pros and cons of both the procedures at the consultation.