Abstract
Background and Study Aims: Endoscopic biliary stenting is often used for large or difficult common bile duct
(CBD) stones that cannot be extracted at one session. We compared the sizes of the
CBD stones after a period of stenting.
Patients and Methods: Over a 6-year period, a total of 444 patients with large CBD stones (> 2 cm diameter)
or difficult CBD stones were managed in our endoscopy unit, of which 46 were treated
by endoscopic stenting. Twenty-eight had second ERCP for stone removal after a median
period of 63 days (range 17-1002 days). The largest diameter of the stones and the
CBD (after correction of magnification) before and after stenting were compared using
the Wilcoxon signed test.
Results: Before stenting the largest diameters of CBD stones were 11-46 mm (mean 24.9 mm)
and decreased to 5-46 mm (mean 20.1 mm) after stenting. The difference in stone sizes
was statistically significant although the CBD diameter pre- and post-stenting was
not significantly different. The reduction in stone sizes was not significantly correlated
with the duration of stenting.
Conclusion: CBD stones became smaller after stenting. As the difficulty of stone extraction increases
with stone size, a period of stenting may make subsequent removal easier for patients
with large or difficult CBD stones.
