A Comparative Study of the Imaging and Treatment Modalities in the Management of Choledocholithiasis

Abstract

The objectives of this study are to compare the investigative modalities used in the diagnosis and to compare the treatment undertaken in the management of patients with choledocholithiasis. MATERIAL AND METHODS Data was collected in prefixed proforma in our hospital between April 2012 to Oct 2014 after considering inclusion and exclusion criteria.  Data regarding imaging studies for diagnosis of choledocholithiasis was collected.  After diagnosis, patients were subjected to different treatment modalities.  The outcomes, complications and morbidity of the procedures were compared analysed. RESULTS  Mean age was more than 50 years. Pain abdomen was the most common preventing complaint.  Ultrasound was the commonest imaging modality done with sensitivity of more than 60% in finding the CBD stone  CT and MRCP in diagnosis of choledocholithiasis were concerned and dilatation of the common bile duct was detected equally by both methods.  ERCP and surgical methods in form of laparoscopic or open surgery were different treatment modalities used; ERCP was the common treatment modality done. Open surgery and laparoscopic cholecystectomy were next commonest treatment modalities done respectively. CONCLUSIONS  Occurrence of choledocholithiasis increases with age.  USG is both cheap and effective with sensitivity more than 60% but MRCP is more preferable as a biliary imaging modality.  Choledochoduodenostomy is an optional method of management following CBD exploration while T-tube drainage and primary closure of the CBD following exploration have comparable results.