ERCP CBD Stone

ERCP CBD Stone

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What is Bile Duct?

The organs of your biliary system are connected via bile ducts. Your bile ducts’ ability to function depends on these organs. When and wherever bile is required, they transmit it using the ducts. Any number of issues may arise if your bile ducts get dilated or become blocked by an obstruction.

What are the symptoms of stones in the bile duct after gallbladder removal?

Abdominal Pain:
Pain in the upper right abdomen is a common symptom. It can be intermittent or constant and may be triggered by eating fatty or greasy foods.

Jaundice:
This is a yellowing of the skin and eyes due to an accumulation of bilirubin in the body. It can occur if a stone obstructs the bile duct.

Fever and Chills:
If a stone leads to an infection in the bile duct, it can cause fever and chills.

If there is a stone in the bile duct then how do we diagnose it?

Blood Tests:
Liver Function Tests (LFTs): Elevated levels of certain liver enzymes (such as alkaline phosphatase, bilirubin, and transaminases) can suggest a blockage in the bile duct.

Amylase and Lipase:
These enzymes may be elevated if the stone is causing pancreatitis (inflammation of the pancreas).

Ultrasound:
This non-invasive imaging test uses sound waves to create images of the liver, gallbladder, bile ducts, and surrounding organs. It can help identify stones and their location.

MRI/MRCP (Magnetic Resonance Cholangiopancreatography):
This imaging technique uses magnetic fields and radio waves to create detailed images of the bile ducts. MRCP is particularly useful for visualizing the biliary system.

Endoscopic Retrograde Cholangiopancreatography (ERCP):
This is both a diagnostic and therapeutic procedure. It involves the insertion of an endoscope (a flexible tube with a camera) through the mouth, down the esophagus, and into the duodenum. A contrast dye is then injected, and X-rays are taken to visualize the bile ducts.

Blood Tests for Pancreatic Enzymes:
Elevated levels of amylase and lipase may indicate pancreatitis, which can be caused by a blocked bile duct. The choice of diagnostic tests will depend on the specific situation, the availability of equipment, and the references of the healthcare provider. In some cases, multiple tests may be used to confirm the diagnosis and gather comprehensive information about the stone and its impact on the bile duct.

How to treat bile duct stones?

Endoscopic Retrograde Cholangiopancreatography (ERCP):
This is a common procedure used to remove bile duct stones. During ERCP, an endoscope (a thin, flexible tube with a camera) is passed through the mouth, down the esophagus, and into the duodenum. A small incision is made in the ampulla of Vater (the opening where the bile duct and pancreatic duct enter the small intestine) and a catheter is inserted to inject contrast dye and visualize the bile ducts. Special tools are used to remove or break up the stones.

Sphincterotomy:
During an ERCP, the surgeon may perform a sphincterotomy, which involves cutting the muscle around the ampulla of Vater. This widens the opening, making it easier to remove stones.

Balloon Dilation:
In cases where the duct is narrowed due to a stone, a balloon may be used to widen the area and facilitate stone removal.

Bile Duct Stent Placement:
In some cases, a stent (a small tube) may be inserted into the bile duct to keep it open. This can be a temporary measure to alleviate blockage while a more definitive treatment plan is determined.