Spontaneous passage of common bile duct stones in jaundiced patients

BACKGROUND: Common bile duct (CBD) stones are known to pass spontaneously in a significant number of patients. This study investigated the rate of spontaneous CBD stones passage in a series of patients presenting with jaundice due to gallstones. The patients were managed surgically, allowing CBD intervention to be avoided in the event of spontaneous passage of CBD stones. METHOD: Retrospective analysis of patients presenting with jaundice due to CBD stones, and managed surgically with laparoscopic cholecystectomy and intra-operative cholangiogram with or without CBD exploration. RESULTS: The jaundice settled pre-operatively in 76/108 patients, and in 60/108 the CBD stones had passed spontaneously by the time of surgery These 60 patients avoided any intervention to their CBD. CONCLUSIONS: CBD stones pass spontaneously in more than half of jaundiced patients. Surgical management (laparoscopic cholecystectomy and intra-operative cholangiogram, with willingness to perform CBD exploration if positive) allows the avoidance of CBD intervention in these patients.