Ann Hepatobiliary Pancreat Surg.  2019 Feb;23(1):41-45. 10.14701/ahbps.2019.23.1.41.

Epidemiology and disease characteristics of symptomatic choledocholithiasis in Sri Lanka

• De Silva W
• Pathirana
• Wijerathne TK
• Gamage BD
• Dassanayake BK
• De Silva M

• KMID: 2439044
• DOI: http://doi.org/10.14701/ahbps.2019.23.1.41

Abstract

BACKGROUNDS/AIMS
Published data on choledocholithiasis in Sri Lanka is scarce. This study was conducted to determine epidemiological, clinical and endoscopic characteristics of choledocholithiasis in Sri Lanka.
METHODS
This was a retrospective study of consecutive patients for a period of three years until April 2016. The sample included patients from many parts of the island. Patients were selected from the endoscopy database of the unit and the data were collected from the records of the patients.
RESULTS
A total of 253 patients were included in the study. The mean age of the patients was 53.6 years. Patients presented with obstructive jaundice (58.5%), cholangitis (25.3%), biliary colic or upper abdominal pain (14.2%) and acute biliary pancreatitis (1.8%). There were 26 (10.3%) post cholecystectomy patients. Concomitant gallbladder stones were found in 173 patients (68.4%). Juxta-papillary diverticula were found in 36 patients (14.2%). Twenty-one (8.3%) and nine patients (3.6%) were found to have choledochal cysts and common bile duct strictures, respectively. Stones were commonly found in the distal common bile duct (68.4%). A majority of the patients had a single stone (47.8%). In 209 patients (79.6%), the size of the largest stones measured between 0.5-1.5 cm.
CONCLUSIONS
Choledocholithiasis is a disease affecting middle-aged population with predominance among females in Sri Lanka. Patients with symptomatic choledocholithiasis commonly present with obstructive jaundice. In the present study, most of the stones were formed in anatomically normal biliary systems. Stones were predominantly distal, single and measured 0.5-1.5 cm in size. The observed features were favorable features for successful endoscopic clearance. None of the patients included in the study had primary CBD stones according to the available criteria.

Keyword

Common bile duct stones; Symptomatic choledocholithiasis; Choledocholithiasis in Sri Lanka; Juxta-papillary diverticula; Primary common bile duct stones

MeSH Terms

Abdominal Pain
Biliary Tract
Cholangitis
Cholecystectomy
Choledochal Cyst
Choledocholithiasis*
Colic
Common Bile Duct
Constriction, Pathologic
Diverticulum
Endoscopy
Epidemiology*
Female
Gallbladder
Humans
Jaundice, Obstructive
Pancreatitis
Retrospective Studies
Sri Lanka*

Figure

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  Fig. 1 Distribution of patients according to the age.

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