Real-World Natural History of Choledocholithiasis in A Tertiary Care Center of Western India

Background: There is lack of definitive data or guidance regarding the optimal timing regarding management of choledocholithiasis from its diagnosis till definitive treatment.

Aim: To observe the real-world timeline of patients with choledocholithiasis from the point of diagnosis till the completion of their treatment.

Methodology: It is retrospective analysis of patients with choledocholithiasis presented to our center from August 2023 to January 2024. The treatment protocol included stenting with or without clearance, subsequent cholecystectomy after the clearance of the CBD, ultimately stent removal.

Result: A total of 44 patients were enrolled, mean age of 50 years, 20 (45.45%) were male, cholelithiasis was present in 34 (77.27%), 6 (13.63%) had cholangitis at presentation, mean stone size was 8.32 mm. Mean total number of ERCPs needed till stent removal was 3. CBD was cleared in index ERCP in 25 (56.81%), cholangitis episodes after CBD clearance in those awaiting cholecystectomy occurred in 20 (45.45%).

Timeline	Days
Median time from diagnosis to ERCP	7
Median duration from index ERCP to cholecystectomy	119
Median duration from cholecystectomy to stent removal	101
Median duration from the diagnosis to stent removal	314

Conclusion: There is delay in the cholecystectomy after index ERCP and in stent removal post cholecystectomy. This is either because of lack of awareness about the risk associated with incomplete treatment or because of long waiting period at government hospital.

Publication History

Article published online:
22 April 2024