Role of biliary stenting in management of large or multiple common bile duct stones

Abstract

Background Common bile duct (CBD) stones are seen in ∼7–12%. They vary in size ranging from rather small (∼1–2 mm) to very large (>3 cm). Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy and basket or balloon extraction are well-established therapeutic procedures for the management of CBD stones. Aim The aim of the present study was to assess the role of biliary stenting in management of large or multiple CBD stones by comparison between stone size, number, and index between both sessions of ERCP, with average duration of 2 months. Patients and methods A total of 25 patients referred to our center with radiological evidence of large CBD stones (≥2 cm) and/or multiple stones (≥3) were included. Initial ERCP with biliary stenting was performed. After 2 months or more, second-look ERCP was performed with stone extraction, with comparison of stone number, size, and index between both sessions. Results Our study showed statistical significant reduction in stone size, index, and number, with availability of stones removal in the second session. Moreover, reduction in bilirubin level was observed. Conclusion In conclusion, temporary biliary stenting within an average of 2 months has a role in the management of large and multiple CBD stones and will facilitate stone extraction.