CBD Stone Removal - Kya hota hai, Causes, Symptoms, Tests & Treatment | Choledocholithiasis in Hindi

CBD Stone Removal - Kya hota hai, Causes, Symptoms, Tests & Treatment | Choledocholithiasis in Hindi
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Hello friends, today we will talk about CBD stones, also known as choledocholithiasis.
What causes it? What are its symptoms? What tests are conducted to diagnose it? And how do we manage it?
Choledocholithiasis, or CBD stones, refers to the presence of stones within the common bile duct (CBD). The CBD is essentially a duct that carries bile from the liver to the intestine through two ducts, left and right hepatic ducts. If a stone is present in the bile duct, it is known as a CBD stone or choledocholithiasis.
The most common cause of CBD stones is a stone formed in the gallbladder slipping into the CBD. Other conditions that might lead to stone formation in the CBD include situations where excessive stones are formed, structures or tumors obstructing the bile flow, and any swelling in the bile ducts known as choledochal cysts.
Symptoms of CBD stones include right upper abdominal pain, jaundice, fever (if an infection is present), and potentially severe pain radiating to the back if the stone touches the pancreatic duct, leading to pancreatitis.
When you visit a doctor, they may suspect CBD stones based on a clinical examination. Blood tests can show elevated liver enzymes and alkaline phosphatase levels, indicating a potential obstruction in the CBD. Imaging studies like ultrasound can detect stones in many patients, but an MRI, especially an MRCP (Magnetic Resonance Cholangiopancreatography), might be required for a clearer view.
Most cases of CBD stones are managed with an ERCP (Endoscopic Retrograde Cholangiopancreatography). This involves inserting a long scope through the mouth to reach the small intestine, where a stent is placed in the CBD to extract the stones using a basket or balloon. The advantage of ERCP is that it’s minimally invasive, with no cuts on the skin or CBD itself, reducing the risk of complications. However, if there are many stones or very large stones, ERCP might not be sufficient.
An alternative is laparoscopic CBD exploration, similar to gallbladder surgery, where small incisions are made to remove the stones. In cases with recurrent stones or structural issues, a bypass surgery may be performed to connect the upper part of the CBD or the cystic duct directly to the small intestine to ensure bile flows directly, preventing further stone formation.
To prevent CBD stones, there is no guaranteed method, but if you have gallbladder stones causing issues, it’s best to get surgery done early to prevent them from slipping into the CBD.
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