Gut. Published Online First: 5 March 2008. doi:10.1136/gut.2007.121657
Guidelines |
Guidelines on the management of common bile duct stones
1 Royal Liverpool University Hospital, United Kingdom
2 City General Hospital, Stoke on Trent, United Kingdom
3 University Hospital Nottingham, United Kingdom
4 Royal Infirmary of Edinburgh, United Kingdom
5 Wythenshawe Hospital, United Kingdom
* To whom correspondence should be addressed. E-mail: martin.lombard{at}rlbuht.nhs.uk.
Accepted 22 January 2008
Abstract
The last 30 years has seen major developments in the management of gallstone related disease, which in the United States alone costs over 6 billion dollars per annum to treat (1). Endoscopic retrograde cholangio- pancreatography (ERCP) has become a widely available and routine procedure, whilst open cholecystectomy has largely been replaced by a laparoscopic approach, which may or may not include laparoscopic exploration of the common bile duct (LCBDE). In addition new imaging techniques such as Magnetic Resonance imaging (MR) and Endoscopic Ultra-Sound (EUS) offer the opportunity to accurately visualise the biliary system without instrumentation of the ducts. As a consequence clinicians are now faced with a number of potentially valid options for managing patients with suspected CBDS. It is with this in mind that the following guidelines have been written.
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