Litholytic effect of stirring by plastic stent inside biliary tract in large common bile duct stone

Abstract

Objective To investigate the litholytic effect of stirring by plastic stem inside biliary tract in large common bile duct (CBD) stone. Methods Forty-five patients with large CBD stones were included in this study (8 with the distal bile duct stricture and 5 with too-small Vater's papilla).Plastic stent of 8.5Fr was inserted into the CBD under the guidance of guide wire in all the 45 patients. Results In 10 of the 45 patients, ERCP showed that there was no stone in CBD 3 months later after stent placement. In 22 cases, repeated ERCP revealed that the stone had become smaller to the extent of more than a half or became stone fragments that were easily extracted by baskets or balloon dilation. Thirteen patients continued to have large stone at the second time ERCP treatment, and a new stent was replaced and follow-up performed by B mode ultrasonography of abdominal region per month. Further endoscopic treatment was performed immediately when the stone became small enough. The percentage of 95.6% (43/45) of large CBD stone were eventually cleared after endoscopic treatment for an average of 2.4 times. There were no severe complications related to ERCP or stent placement. Conclusion Placement of plastic biliary stent is a convenient and effective measure for the treatment of large CBD stones. It is especially appropriate for aged patients of CBD stone of high risk. Key words: Cholelithiasis ; Plastic biliary stent ; Litholytic effect ;