Methods: Patients who had co-morbid illness and elderly patients who are not fit for surgery were included. Endoscopic plastic biliary stenting
was performed in 65 patients with large and/or multiple common bile duct stones or those difficult to extract with conventional endoscopic therapy. Liver function test before and after stenting also recorded. Bile duct drainage click here and endoscopic placement of 7 Fr plastic biliary stents were established in all patients. The diameters of the CBD stones were measured on the radiographs before and after stenting. Results: In this 22 patients has multiple CBD stones (>3) and 46 patients had large stones (>2 cms). Stone retrieval was possible, after a median of 24 days (19–38 days). All patients had reductions in the stone number and/or stone size. In 18 patients there was spontaneous clearance of the stones from the CBD. The median number and size of stones per patient was significantly reduced after biliary stenting compared with before 5 (3) vs 2.0 (1.0) [P < 0.0001] and 2.8 (1.5) to 2.0 (1.0) [P < 0.001] respectively. Liver function test also showed a significant after stenting (p < 0.001). All the stones were black and amorphous in consistency. Conclusion: Plastic
biliary stenting is safe and effective in the management of difficult stones in elderly and high risk patients. It may fragment common bile duct stones and decrease TGF-beta inhibitor stone sizes. Unlike the reports for cholesterol stones, shorter period of deployment is sufficient for pigment stones, because these are either black or mixed and are amorphous, unlike the hard cholesterol stones reported for hard cholesterol stones. Key Word(s): 1. CBD stones; 2. High risk patients; 3. stenting; 4. pigment stones; Presenting Author: YUANYUAN ZHANG Additional Authors: YULAN LIU Corresponding Author: YULAN LIU Affiliations: Gastroenterology
Department of Peking University check details People’s Hospital; Gastroenterology Department of Peking University People’s Hospital Objective: To study the possible association between cholecystectomy and primary common bile duct stones. Methods: We retrospectively reviewed the clinical findings in 339 patients who were diagnosed as common bile duct stones (CBD stones) in Peking University People’s Hospital from May 2000 to October 2010. Results: There were 184 females and 155 males with a mean age of 61.54 ± 14.74 years. We divided the 339 patients into 2 groups, one is CBD stones patients after cholecystectomy (n = 124), and another group without cholecystectomy (n = 215). The mean age of the two groups showing no significance. Clinical manifestations of CBD stones such as abdominal pain, nausea, vomitting and fever showed no difference in two groups, but interestingly, jaundice was found in 21/124 cases of CBD stones after cholecystectomy, and in 66/215 case of CBD stones without cholecystectomy (χ2 = 9.125, P = 0.058). The ALT level (t = −2.802, P = 0.