When is bile duct exploration performed?

If something is blocking the bile duct, bile can back up into the liver. This can cause jaundice, a condition in which the skin and white of the eyes become yellow.

The bile duct might become infected and require emergency surgery if the stone or blockage is not removed. This procedure can be done during the removal of the gall bladder
The CBD is a tube connecting the liver, gallbladder, and pancreas to the small intestine that helps deliver bile to aid in digestion. If a stone or obstruction is blocking the CBD, bile can back up into the liver causing jaundice. Jaundice is when the skin and white of the eyes become yellow.

The CBD might become infected and require emergency surgery if the stone or blockage is not removed.

A CBD exploration is the opening of the duct to evacuate a stone that is causing a blockage and jaundice. It is usually performed in conjunction with a Cholecystectomy (gallbladder removal) to prevent the further stone from passing into the CBD. A tube is left after surgery to drain bile into a bag, which will be removed several weeks.

When is it used?

If a stone or obstruction is blocking the CBD, bile can back up into the liver causing jaundice. Jaundice is when the skin and white of the eyes become yellow.

The CBD might become infected and require emergency surgery if the stone or blockage is not removed. This procedure can be done during the removal of the gallbladder.

Common bile duct exploration and stone extraction is typically problematic, tedious, and is accomplished via three surgical options:

1. Open, which is an invasive procedure requiring a longer period of hospitalization and recovery.

2. Endoscopic Retrograde Cholangio-Pancreatography (ERCP), a second procedure that requires an endoscopic specialist (often not available in smaller hospitals), with a 10% complication risk that includes pancreatitis and a 1.0% mortality rate. Patients who develop post ERCP pancreatitis can expect extended hospital stays of 48-94 days. (Waknine, Yael. Gut, Dec. 2003)

3. Laparoscopic Common Bile Duct Exploration (LCBDE) includes either (a) transcystic or (b) choledochotomy procedures and is a minimally invasive operation with the lowest associated morbidity & mortality. No second operation is required and the patient’s diseased gallbladder is removed during the same procedure. LCBDE provides for a quick recovery, a short hospital stay (may even be performed in the ambulatory surgery setting), and has virtually no risk of pancreatitis. An alternative treatment would be an ERCP (endoscopic retrograde cholangiopancreatography). You may discuss these options with your doctor.