Work

Double Plastic Stents as a Bridging Strategy for Large Common Bile Duct Stones: A Case Report of Two Patients

Year: 2025

Type: article

Abstract: Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy is the standard treatment for common bile duct (CBD) stones. However, in 10-15% of cases involving large or multiple stones, this approach is inadequate. Advanced techniques such as lithotripsy, dilation, balloon extraction, or surgery may be required. Case Presentation: We present 2 post-cholecystectomy patients with large (>1.5 cm), multiple impacted CBD stones. Initial ERCP attempts, including sphincterotomy and 15-mm balloon dilation, failed to clear the stones. As a bridging strategy, two plastic stents (10 Fr and 7 Fr) were placed, and ursodeoxycholic acid therapy was started. On re-evaluation at 50 and 80 days, stone clearance was achieved using simple balloon extraction - without lithotripsy or cholangioscopy - using the same tools as the initial ERCP. Conclusion: Double plastic stent placement can serve as an effective interim measure for complex CBD stones, facilitating complete clearance in subsequent ERCP with standard equipment.

Source: Case Reports in Gastroenterology

DOI: 10.1159/000548211

Author: Anupam Kumar Gupta

Institution: Good Samaritan Hospital

Language: English

Topic: Gallbladder and Bile Duct Disorders

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,030