Abstract
Introduction: Inflammation of Gallbladder (cholecystitis) occurs commonly due to obstruction of cystic duct usually by gall stones (cholelithiasis). It is challenging to clinically differentiate Calculus cholecystitis from choledocolithiasis as both conditions have similar presentation but differ widely in management protocols. Laparoscopic cholecystectomy is sufficient in the former while if the latter is suspected, endoscopic retrograde cholangio-pancreatography (ERCP) and common bile duct (CBD) stent needs to be placed which if failed to remove in time might present with complications due to biliary stasis.
Case Presentation: Here we report a similar case of a 36year male patient having retained double CBD stent (for 22months) with calculus cholecystitis and choledocolithiasis.
Discussion: Stents may remain without complications or may migrate, and rarely form nidus for stone formation. If kept for long time they lead to bacterial proliferation, biofilm formation and precipitation of calcium bilirubinate presenting as fever, pain, jaundice. Stent-stone complex can be treated endoscopically and surgically[6,7]. As stent can cause stone formation, infection and other complications, timely removal of stent should advised.
Conclusion: III-effects of stent in-situ should be explained, record should be maintained [8] and patient should be advised regular follow up and stent removal after 6 weeks.
Keywords: cholecystitis, choledocolithiasis, Laparoscopic cholecystectomy, ERCP, CBD Stenting, retained double CBD stent.
References
- Yoo K.S., Lehman G.A. Endoscopic management of biliary ductal stones. Gastroenterol. Clin. North Am. 2010;39:209–227. viii. [PubMed] [Google Scholar]
- Bansal V.K., Mishra M.C., Bhowate P. Laparoscopic management of common bile duct stentolith. Trop. Gastroenterol. 2009;30:95–963. [PubMed] [Google Scholar] unlabelledb. Schuller A.M., Rezk G.J., Lyon D.T. Calculus formation around common bile duct stents: a complication of long- term biliary drainage. ([letter]) Gastrointest. Endosc. 1991;37:581–582. [PubMed] [Google Scholar]
- Schuller A.M., Rezk G.J., Lyon D.T. Calculus formation around common bile duct stents: a complication of long- term biliary drainage ([letter]) Gastrointest. Endosc. 1991;37:581–582. [PubMed] [Google Scholar]
- Grubnik V.V., Tkachenko A.I., Ilyashenko V.V. Surg. Endosc. 2012;26:2165. [PubMed] [Google Scholar]
- Ko C.W., Lee S.P. Epidemiology and natural history of common bile duct stones and prediction of disease56. Gastrointest. Endosc. 2002;56(Suppl. 6):S165–S169. Review. PubMed PMID: 12447261. [PubMed] [Google Scholar]
- Moss A.C., Morris E., MacMathuna P. Palliative biliary stents for obstructing pancreatic carcinoma. Cochrane Database Syst. Rev. 2006;(1):CD004200. Review. Update in Cochrane Database Syst Rev. 2006; (2):CD004200. PubMed PMID: 16437477. [PubMed] [Google Scholar]
- Leung J.W., Sung J.Y., Costerton J.W. Bacteriological and electron microscopy examination of brown pigment stones. J. Clin. Microbiol. 1989;27 915–215. [PMC free article] [PubMed] [Google Scholar]
- Speer A.G., Cotton P.B., Rhode J., Seddon A.M., Neal C.R., Holton J.W. Billiary stent blockage with bacterial biofilm. Ann. Intern. Med. 1988;108:536–546. [PubMed] [Google Scholar]
- Siegel J.H., Yatto R.P. Biliary end prostheses for the management of retained common bile duct stones. Am. J. Gastroenterol. 1984;79:50–547. [PubMed] [Google Scholar]
- Cotton P.B. Stents for stones: short-term good, long-term uncertain. ([editorial]) Gastrointest. Endosc. 1995;42:272–273.8. [PubMed] [Google Scholar]
- Odasbasi Mehmet, Arslan Cem, Akbulut Sani, Hasan Abuoglu Haci. Long-term effects of forgotten biliary stents:a case series and literature review. Int. J. Clin. Exp. Med. 2014;7(8):2045–2052. [PMC free article] [PubMed] [Google Scholar]
Corresponding Author
Dr Deepak J Vora
Associate Professor, Professor, Resident Doctors At Smt Shardaben Hospital, Smt NHLMMC, Ahmadabad
DOI: https://dx.doi.org/10.18535/jmscr/v9i9.22
