COMMON BILE-DUCT STONES BECOME SMALLER AFTER ENDOSCOPIC BILIARY STENTING

Background and Study Aims: Endoscopic biliary stenting is often used f or large or difficult common bile duct (CBD) stones that cannot be ext racted 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 tot al of 444 patients with large CBD stones (>2 cm diameter) or difficult CBD stones were managed in our endoscopy unit, of which 46 were treat ed by endoscopic stenting. Twenty-eight had second ERCP for stone remo val 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 te st. 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 correla ted with the duration of stenting. Conclusion: CBD stones became small er after stenting. As the difficulty of stone extraction increases wit h stone size, a period of stenting may make subsequent removal easier for patients with large or difficult CBD stones.