Clinical study of the accuracy of observing CBD remnant stones by injection of saline through ENBD under US guidance

Yan-Bo Liu, Shuo-Dong Wu. Department of the Second General Surgery, Shengjing Hospital of China Medical University, Shenyang City, Liaoning Province, People’s Republic of China

Objective: To investigate the accuracy of observing commo bile duct (CBD) remnant stones by injection of saline through endoscopic nasobiliary drainage (ENBD) under the guidance of ultrasound.

Methods: ENBD was routinely placed in 58 patients with CBD stones who underwent endoscopic stone extraction. Ultrasound examination was performed 3 to 5 postoperative days. After routine examination by a professional ultrasound doctor, 50-200ml saline was injected through ENBD slowly. Ultrasonic results, including changes of bile duct diameter and detection rate of CBD remnant stones, was compared.

Results:  Among the 58 patients, CBD remnant stone was detected in 1 patient before injection and failure of injection occurred in 1 patient due to the damage of ENBD; 2 patients showed bad tolerance of abdominal pain after injection of 20ml saline. No significant change of the diameter of the CBD after injection was observed in 1 patient, while obvious dilation of the diameter of the CBD was observed in the other 56 patients after injection. In these 56 patients, the lower end of the CBD which is interfered by intestinal gas before injection appeared more clearly after injection. Of the 57 patients who underwent injection, CBD remnant stones were detected in 6 patients with the detection rate 10.5%(6/57), which was significantly increased compared with the detection rate 1.72%(1/58)before injection.

Conclusions: The accuracy of observing CBD remnant stones by injection of saline through ENBD under the guidance of ultrasound is significantly improved..

Key words: common bile duct remnant stones; ultrasound; ENBD; saline injection

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