Title: Retained Double CBD Stent with Calculus Cholecystitis
Authors: Dr Deepak J Vora, Dr Sharad M Patel, Dr Tirth B Shah, Dr Shubham Patel, Dr Raj Depani
DOI: https://dx.doi.org/10.18535/jmscr/v9i9.22
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.
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