Article:
Surgical treatment of bile duct stones after failed endoscopic management

creativeworkseries.issn1999-6217
dc.contributor.authorKandel, Bishnu Prasad
dc.contributor.authorKoirala, Nishnata
dc.contributor.authorSharma, Deepak
dc.contributor.authorMaharjan, Narendra
dc.contributor.authorMaskey, Sumita Pradhan
dc.contributor.authorBhandari, Ramesh Singh
dc.contributor.authorLakhey, Paleswan Joshi
dc.creator.affiliationDepartment of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine , Tribhuvan University, Kathamndu, Nepal.
dc.creator.affiliationDepartment of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine , Tribhuvan University, Kathamndu, Nepal
dc.creator.affiliationDepartment of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine , Tribhuvan University, Kathamndu, Nepal.
dc.creator.affiliationDepartment of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
dc.creator.affiliationDepartment of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
dc.creator.affiliationDepartment of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
dc.creator.affiliationDepartment of Surgical Gastroenterology, Tribhuvan University Teaching Hospital, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
dc.date.accessioned2026-09-15T10:08:45Z
dc.date.available2026-09-15T10:08:45Z
dc.date.issued2025
dc.description.abstractAbstract: Background: Bile duct calculi occur in a significant proportion of patients with cholelithiasis. They are usually managed by endoscopic methods, but surgical management is needed in complicated cases. The choice of a specific surgical procedure depends on various factors, such as the extent of bile duct dilation, the location of stones, and the presence of stricture or fistula. In this study, we described the different surgical procedures and their outcomes for patients with bile duct stones that could not be cleared by endoscopic methods. Methods: This is a retrospective cross-sectional study of patients who underwent different surgical procedures for bile duct stones. Patients treated from January 2022 to December 2024 were included in the study. Demographic and clinical data were obtained from medical records and analyzed. Results: There were 55 patients, of whom 36 were female. Pain in the abdomen and jaundice were the most common symptoms. Laparoscopic common bile duct exploration was done in 10 (18.2%) patients. Bile duct stones along with biliary fistulas, hepatolithiasis, or liver atrophy were present in 16(29.1%) cases. Besides bile duct exploration, other procedures, including choledochoduodenostomy or hepaticojejunostomy(14.5% ), choledochoplasty (5.5%), and liver resection (12.7%), were required for the management of these patients. There was no mortality, but two (3.6%) patients had residual stones, and eight (14.5%) patients developed major complications with Clavien-Dindo grade three or more. Conclusions: Bile duct calculi that could not be cleared by endoscopic methods require surgical intervention. CBD exploration in combination of other required procedures can be performed for the management of bile duct stones and their complications with good outcomes.
dc.identifier.doihttps://doi.org/10.33314/jnhrc.v23i02.4695
dc.identifier.urihttps://hdl.handle.net/20.500.14572/7701
dc.language.isoen_US
dc.publisherNepal Health Research Council
dc.subjectBile duct
dc.subjectBile duct exploration
dc.subjectCholelithiasis
dc.subjectCholedocholithiasis
dc.subjectHepatolithiasis
dc.titleSurgical treatment of bile duct stones after failed endoscopic management
dc.typeArticle
dspace.entity.typePublication
local.article.typeOriginal Article
oaire.citation.endPage384
oaire.citation.startPage377
relation.isJournalIssueOfPublication5df7ea21-413e-4c7e-92f6-f85d6e7a64ef
relation.isJournalIssueOfPublication.latestForDiscovery5df7ea21-413e-4c7e-92f6-f85d6e7a64ef
relation.isJournalOfPublication40bd2739-8b19-447c-be60-723a1bdd1dcd

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