Evaluation of bile duct stones extracted by ERCP (Endoscopic Retrograde Cholangio-Pancreatography).

Abstract

Objective: To determine the frequency of different types of gallstones on ERCP stone extraction from bile duct. Study Design: Cross Sectional study. Setting: Department of Gastroenterology of the Nishtar Hospital Multan. Period: September 2019 to October 2020. Material & Methods: Patients with bile duct stones on imaging of either sex aged 18 – 70 years were included in our study while patients with IHD, malignancies, liver cirrhosis, asthma, TB, COPD, ILD and pregnant women were excluded from our study. During ERCP the gross appearance of extracted stones and related findings were noted. Results: Our study included 139 patients meeting inclusion criteria, of these 139 study cases, 49 (35.3%) were male and 90 (64.7%) were female patients with bile duct stone. Mean age was 45.78 ± 12.05 year (range; 27 – 68 years). Of these 139 study cases, 56 (40.3%) were from rural areas, 83 (59.7 %) were from urban areas, 52 (37.4%) had poor socioeconomic status and 87 (62.6%) were from middle income family background. Diabetes was noted in 35 (25.2%), hypertension in 53 (38.1%) and obesity in 32 (23 %) (Mean BMI was 26.53±214kg/m²). Mean stone size in our study was 15.82 ± 6.34 mm while 78 (56.12 %) had single stones. Pure cholesterol gallstones were noted in 47 (33.8%), mixed cholesterol stones in 71 (51.1%) and brown pigmented gall stones in 21 (15.1%). Conclusion: Mixed cholesterol stones were more frequent followed by pure cholesterol and brown pigmented stones in bile duct gallstones patients. Mixed cholesterol stones were significantly associated with rural residential status and hypertension while brown pigmented stones were residential status, hypertension and obesity.