CBD Stone

When you are diagnosed with gall bladder stones and you are having symptoms like abdomen pain, bloating etc. then the surgeon suggests to get the surgery for gall bladder removal done. However many patients tend to wait rather than getting the surgery done. There is a narrow vessel called Common Bile Duct that connects the Liver to the gall bladder. Bile Juice from the Liver comes into the Gall Bladder through this duct. Stones can sometime get stuck in the common bile duct and block the flow of bile juice from the Liver to the Gall Bladder. This mostly happens when the stones in gall bladder are multiple and small in size. This causes Jaundice and can result in great damage to the Liver. In such cases the Gastroenterologist removes the CBD stones using an Endoscope in a procedure called Endoscopic Retrograde Cholangio- Pancreatography (ERCP). In some cases if the stone cannot be removed then a stent is placed to bypass the blocked vessel and create a path for the flow of the bile juice. Normally the gastroenterologist breaks the stone in smaller pieces and extracts them. However if the CBD stone is stuck in such a manner that it cannot be removed through Endoscope then an open surgery is done from the front of the chest.

Patients presenting with CBDS have symptoms including biliary colic, jaundice, cholangitis, pancreatitis or may be asymptomatic. There are several techniques to remove CBD stones and one of the most common and best technique is to do ERCP for CBD Stones.

Treatment Options

ERCP as a diagnostic test has been mostly replaced by a non invasive test called MRCP. Magnetic Resonance Cholangio Pancreatography (MRCP) is a technique for viewing the bile duct and the pancreatic duct. It can also show the pancreas, gallbladder and liver. MRCP uses magnetic resonance imaging (MRI) to produce detailed pictures of these ducts and organs.

Most of the patients with CBD stones also have Gall Stones. In such cases the Gall Bladder is removed using a Laparoscope and the surgery is called Laparoscopic Cholecystectomy. In such cases the surgeon can also do Laparoscopic Common Bile Duct Exploration (LCBDE). In some cases the surgeon would do Laparoscopic Cholecystectomy and the Gastroenterologist would do ERCP in the same sitting. In other cases ERCP is done first to remove the CBD stones and Lap Chole is done after a few days.

If GB stones are detected at the time of laparoscopic cholecystectomy, the best treatment is a trans-cystic laparoscopic approach during the same operation. If this fails alternate approaches such as intraoperative or postoperative ERCP, laparoscopic choledochotomy, or open CBDE may be used . A trans-cystic approach is generally used for small stones in a small bile duct whereas trans-ductal approach is preferred for large occluding stones in a large duct, intrahepatic stones, or a miniscule or tortuous cystic duct.

Best Doctors and Cost

Dr Majid Rasool Wani is one of the most qualified and extensively trained GI Surgeon for providing treatment for CBD Stones at Bahra Hospital. Patients with Gall Stones or CBD Stones normally undergo an Ultrasound examination which finds the presence of these stones. In cases of CBD Stones further testing in the form of MRCP is required. The cost for these investigations is around Rs. 10,000. If Laparoscopic Gall Bladder Surgery is required then the cost would be in the range of Rs. 45,000 - 60,000 while the Cost for ERCP is Rs. 35,000 - 50,000 depending upon whether a stent is used during the surgery or not. The hospital stay for ERCP is just one day while the stay would increase by another day if Lap Chole Surgery is done during the same sitting.

If you have an individual health insurance policy then this surgery is covered after a period of 2 years from the date of inception of the policy. However if you are a beneficiary of company given policy then the surgery is covered from day one. Always go through the terms of your health insurance policy like room rent capping and co-payment to avoid any kind of financial shocks later on.

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Bahra Superspecialty Hospital is the biggest private hospital in the Tricity of Mohali, Chandigarh and Panchkula. Spread over 12 acres, the hospital has 250 beds at present which can be expanded to 1000 beds. Mr. Gurvinder Singh Bahra who is one of the most distinguished educationist in India has setup this hospital in the Kharar area of Mohali, Punjab.

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