Updated guideline on the management of common bile duct stones (CBDS)

TLDR

Common bile duct stones affect 10–20 % of symptomatic gallstone patients, causing pain, jaundice, infection, and pancreatitis, and are diagnosed by imaging with treatment options such as ERCP, surgery, and radiological extraction, leaving clinicians with multiple valid diagnostic and therapeutic choices. This guideline updates clinicians on the management of adult patients with suspected or proven CBDS. The recommendations incorporate recent developments and systematic reviews, reflecting changes in evidence since the 2008 British Society of Gastroenterology guideline. It is not a protocol and the recommendations should not replace individual clinical judgement.

Abstract

Common bile duct stones (CBDS) are estimated to be present in 10–20% of individuals with symptomatic gallstones. They can result in a number of health problems, including pain, jaundice, infection and acute pancreatitis. A variety of imaging modalities can be employed to identify the condition, while management of confirmed cases of CBDS may involve endoscopic retrograde cholangiopancreatography, surgery and radiological methods of stone extraction. Clinicians are therefore confronted with a number of potentially valid options to diagnose and treat individuals with suspected CBDS. The British Society of Gastroenterology first published a guideline on the management of CBDS in 2008. Since then a number of developments in management have occurred along with further systematic reviews of the available evidence. The following recommendations reflect these changes and provide updated guidance to healthcare professionals who are involved in the care of adult patients with suspected or proven CBDS. It is not a protocol and the recommendations contained within should not replace individual clinical judgement.