Repeat ultrasonography and MRCP after the pain had subsided in patients who presented with acute abdomen caused by a single common bile duct stone

Abstract

Objective To analyze the clinical value of repeat ultrasonography and MRCP in patients who presented with acute abdomen caused by a single common bile duct stone after the pain had subsided. Methods The clinical data of 46 patients who were diagnosed to have a single common bile duct stone and presented with acute abdomen admitted to the Department of Hepatobiliary and Pancreatic Surgery and Minimally Invasive Surgery in Zhejiang Provincial People's Hospital were retrospectively studied. The patients were treated with anti-infection, antispasmodic and choleretic drugs with other conservative symptomatic and supportive therapy. Ultrasound and MRCP examinations were carried out before and after conservative treatment of the acute abdominal pain. Results 26 (56.5%) patients with a single stone in the common bile duct passed the stone spontaneously. Of these patients, 11 patients were discharged home and were treated conservatively, 15 patients underwent LC, and 20 (43.5%) patients still had choledocholithiasis. Of these 20 patients, 12 underwent ERCP+ EST, followed by LC; while the remaining 8 patients had a history of cholecystectomy, 6 and 2 patients underwent ERCP+ EST and LCBDE, respectively. Conclusion A single common bile duct stone in patients who presented with acute abdomen may pass the stone spontaneously as shown in this study using ultrasound and MRCP examinations. Key words: Acute abdominal pain; Choledocholithiasis; Surgical treatment; Endoscopic the-rapy; MRCP