Indications for common bile duct exploration

The gallbladder secretes bile to aid digestion. If you have problems with your gallbladder, you can go to the hospital for surgery. There is a method called common bile duct exploration, which is a treatment method specifically for the gallbladder. It can effectively detect gallbladder diseases and provide targeted treatment. Many people do not understand this method. Today, follow the editor to learn about what are the indications for common bile duct exploration?

During cholecystectomy, common bile duct exploration should be performed simultaneously in the following situations:

Preoperatively: B-ultrasound, MRCP, etc. indicate that there are multiple stones larger than 1 cm in the common bile duct or stones in the intrahepatic bile duct, and the common bile duct is dilated, and obstruction at the lower end of the common bile duct is suspected, but it cannot be confirmed. There are clinical manifestations and medical history of obstructive jaundice, recurrent biliary colic, cholangitis, and a history of pancreatitis.

Intraoperative: Intraoperative cholangiography confirmed the presence of stones, bile duct obstruction or bile duct dilatation. During the operation, stones, ascariasis or masses were palpated in the common bile duct, or the common bile duct was found to be dilated with a diameter of more than 1 cm and obvious thickening of the wall, or symptoms of pancreatitis were found, or the common bile duct was punctured to extract purulent or bloody bile or muddy bile pigment particles.

Small gallstones may pass through the cystic duct into the common bile duct. It is also possible that small gallstones may be squeezed into the common bile duct during LC surgery.

I haven't seen any specific regulations for postoperative care.

① Acute suppurative cholangitis; ② Stones or foreign bodies in the common bile duct; ③ Obstructive jaundice; ④ Liver and bile duct lesions found during intraoperative exploration or angiography; ⑤ Obvious dilatation of the common bile duct; ⑥ Enlargement of the pancreatic head and obvious dilatation of the common bile duct; ⑦ History of obstructive jaundice.

(1) Absolute indications for exploration: ① stones are palpable in the common bile duct; ② cholangitis and jaundice are present during surgery; ③ intraoperative cholangiography shows bile duct stones; ④ the common bile duct is dilated with a diameter exceeding 12 mm, but in rare cases, the bile duct is dilated without stones. The positive rate of this point during common bile duct exploration is only about 35%. (2) Relative indications for exploration: ① History of jaundice; ② Small stones in the gallbladder; ③ Chronic atrophic changes in the gallbladder; ④ History of chronic recurrent pancreatitis.