DOI: 10.21276/sasjs.2019.5.3.2

Pages: 142-165

Common bile duct stone, also known as choledocholithiasis, is the presence of gallstones in the common bile duct (thus choledocho-+ lithiasis. Common bile duct stones are one of the medical conditions leading to surgical intervention. They may occur in 3%–14.7% of all patients for whom cholecystectomies are performed [1]. There are multiple approaches for diagnosing common bile duct stone with regard to diagnostic performance characteristics, technical success, safety, and cost effectiveness. One of the main factors in the management is initially the detection of common bile duct stone, before, during, or after cholecystectomy. The main options for treatment are pre- or postoperative ERCP with endoscopic biliary sphincterotomy (EST), laparoscopic or open surgical bile duct clearance. There are other options for the treatment of common bile duct stone such as electrohydraulic lithotripsy (EHL), extracorporeal shockwave lithotripsy (ESWL), dissolving solutions, and laser lithotripsy. It is unlikely that one option will be appropriate for all clinical circumstances in all centers. Variables such as disease status, patient demographics, availability of endoscopic, radiological and surgical expertise, and healthcare economics will all have significant influence on practice.