Treatment Options for Bile Duct Stones and Cholecystitis

Bile duct stones and cholecystitis often require surgical intervention to prevent severe complications such as acute obstructive cholangitis, which can progress to life-threatening conditions like severe cholangitis or acute pancreatitis. Without timely treatment, these complications can significantly increase the risk of morbidity and mortality.

Currently, the primary surgical method involves minimally invasive cholecystectomy combined with common bile duct exploration for stone removal. This approach allows for effective treatment of both the gallbladder and bile duct issues in a single procedure. The decision to place a T-tube after surgery depends on several factors, including the diameter of the bile duct and the extent of inflammation.

In cases where the bile duct is wider than 1 cm and the inflammation is mild to moderate, and if the surgeon is confident that all stones have been successfully removed, primary closure without a T-tube may be considered. However, if the inflammation is severe or the bile duct is narrow, a T-tube is typically placed to ensure proper drainage and healing. This tube is usually removed around two months after surgery, following a cholangiogram to confirm that the duct is clear and healing well.

Patients are encouraged to discuss the best treatment plan with their surgeon, as individual factors such as overall health, severity of symptoms, and previous medical history play a crucial role in determining the most appropriate approach.