Several studies recommend prompt LC following ERCP for
choledocholithiasis and biliary pancreatitis with the aim of decreasing the risk of recurrent pancreatitis, morbidity, and other biliary complications (recurrent common bile duct stones and acute cholecystitis) (1-3).
In most cases of
choledocholithiasis in our study, preoperative ERCP was not possible as we do not have ERCP in our hospital and patients cannot be transferred to other institutes due to financial issues.
The purpose of this study was to evaluate the rate of
choledocholithiasis detection using MRCP, after mild biliary pancreatitis, across different time intervals after index admission and to compare liver chemistry profiles on admission and before MRCP in patients with and without
choledocholithiasis.
Indications for ERCP were
choledocholithiasis, cholangitis, and radiographic or clinical evidence of common bile duct (CBD) obstruction.
The diagnosis of single
choledocholithiasis was made only after sonologist confirmed visualizing entire common duct in one or more than one setting.
Moreover, when performing early endoscopic retrograde cholangiopancreatography (ERCP) for acute cholangitis associated with
choledocholithiasis, if the cholangitis is severe, it is recommended to perform biliary drainage alone [3]; however, in moderate-to-mild cases, there is insufficient evidence regarding whether or not single-session stone removal can be safely performed.
The postoperative course was also complicated by
choledocholithiasis requiring an endoscopic retrograde cholangiopancreatography (ERCP) with stone pulverization and placement of two plastic 10F x 12 cm biliary stents.
There was no Cholelithiasis/
Choledocholithiasis. Pancreas was normal.
Atomi, "Treatment of acute cholangitis due to
choledocholithiasis in elderly and younger patients," Archives of Surgery, vol.
Choledocholithiasis and cholecystitis are also reported (Figure 6).
Zhang et al., "MELD scores and child-pugh classifications predict the outcomes of ERCP in cirrhotic patients with
choledocholithiasis: a retrospective cohort study," Medicine (United States), vol.
Delayed gastric emptying,
choledocholithiasis, irritable bowel syndrome, and elevated gamma glutamyl transferase levels have been associated [11].