Spontaneous passage of common bile duct stones in jaundiced patients

Hepatobiliary Pancreat Dis Int. 2011 Apr;10(2):209-13. doi: 10.1016/s1499-3872(11)60033-7.

Abstract

Background: Common bile duct (CBD) stones are known to pass spontaneously in a significant number of patients. This study investigated the rate of spontaneous CBD stones passage in a series of patients presenting with jaundice due to gallstones. The patients were managed surgically, allowing CBD intervention to be avoided in the event of spontaneous passage of CBD stones.

Method: Retrospective analysis of patients presenting with jaundice due to CBD stones, and managed surgically with laparoscopic cholecystectomy and intra-operative cholangiogram with or without CBD exploration.

Results: The jaundice settled pre-operatively in 76/108 patients, and in 60/108 the CBD stones had passed spontaneously by the time of surgery. These 60 patients avoided any intervention to their CBD.

Conclusions: CBD stones pass spontaneously in more than half of jaundiced patients. Surgical management (laparoscopic cholecystectomy and intra-operative cholangiogram, with willingness to perform CBD exploration if positive) allows the avoidance of CBD intervention in these patients.

MeSH terms

  • Cholangiography
  • Cholecystectomy, Laparoscopic
  • Female
  • Gallstones / complications
  • Gallstones / physiopathology*
  • Gallstones / surgery
  • Humans
  • Jaundice / etiology*
  • Male
  • Remission, Spontaneous
  • Retrospective Studies