COMMON BILE-DUCT STENTING FOR CHOLEDOCHOLITHIASIS - A DISTRICT GENERAL-HOSPITAL EXPERIENCE

The favoured treatment of common bile duct stones is endoscopic sphinc terotomy and stone extraction. The management of those cases where duc t clearance is not possible is controversial. At our institution it ha s been policy to insert an endoluminal stent. We report a retrospectiv e review of the outcome of patients stented for common bile duct stone s. The study population was 14 men and 22 women, with a median age of 73 years (range 23-89 years). Treatment-related morbidity was seen in nine patients (25%), comprising cholangitis (5), pancreatitis (3), and cholecystitis (1). Three of these patients died; all were over the ag e of 75 years and had been stented on a long-term basis. These data su ggest that endobiliary stents can be employed with an acceptable compl ication rate. We suggest that patients under the age of 75 years be st ented only as a temporising measure, but that patients over 75 years o r those unfit on physiological grounds can be stented on a long-term b asis as definitive treatment.