Choledocholithiasis: Clinical Manifestations and Associated Conditions

Abstract

Background: More than 98% of all biliary tract disorders are in some way related to gallstones. Choledocholithiasis refers to the presence of gallstones within the common bile duct (CBD). It represent a clinical problem often involving severe infection, cholangitis and cholestasis. Investigations on the etiology of CBD stones are, however, scarce because of the difficult access to CBD stones and bile. In a clinical series of CBD stones, we studied the symptomatology and associated conditions of CBD stones. Methodology: A total number of 115 patients with CBD stones confirmed by imaging technique who underwent Endoscopic retrograde cholangipancreatography (ERCP) were included in this study and grouped as, Group 1- Patients with CBD stones with Gall Bladder (GB) stones. Group 2- Patients with CBD stones with no stones in GB. Group 3- Patients with CBD stones in postcholecystectomy state. Using standard proforma demographic and clinical details were collected. The statistical software package SPSS for Windows version 15 was used to analyse the data. Results: Out of 115 patients, 51 were males and 64 were females. Mean age of presentation was 49.91 years. Most common presentation of CBD stones was abdominal pain 60.86% followed by jaundice 38.26%.Charcots triad was seen in 33.04%. Most common associated condition was distal CBD stricture (16.5%). In this study 54% of patients had associated GB stones,22% had isolated CBD stones and 24% had CBD stones in postcholecystectomy state. Conclusion: There was no statistically significant difference in clinical presentations, associated features in all the three groups of choledocholithiasis. (P value > 0.238).