Abstract :
Symptomatic common bile duct (CBD) stones can present in many ways. Biliary colic, obstructive jaun-
dice, cholangitis and acute pancreatitis are among the common presentations.
Diagnosing CBD stones also can be confirmed by a lot of diagnostic tests. MRCP and EUS are recent
echniques that have sensitivity higher than 90%. Nevertheless ERCP is still a standard procedure to detect and treat CBD stones. Recently laparoscopic CBD exploration has become possible but its limitation are the size of the stones and expertise of surgeon.
Usually lithotripsy is required for a large stone. Mechanical lithotripsy has been used worldwide and yields
with a very effective result. Lately, there are many special devices can be used to crack the stones. Laser,
electrohydrolic probe, and extracoporial shock wave can fragment stones equally effective. Choosing one tech-
nique over the others is depended on local expertise and availibility. Nevertheless, combinations of these may be necessary in some circumstances.
Key words : CBD stones, lithotripsy, management
[Thai J Gastroenterol 2004; 5(1):29-33]
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file/Thai-Journal-of-gastroenterology-vol-5-no-1-1261403.pdf