title: Updated guideline on the management of common bile duct stones (CBDS).
abstract: Common bile duct stones (CBDS) are estimated to be present in 10-20% of individuals with symptomatic gallstones. They can result in a number of health problems, including pain, jaundice, infection and acute pancreatitis. A variety of imaging modalities can be employed to identify the condition, while management of confirmed cases of CBDS may involve endoscopic retrograde cholangiopancreatography, surgery and radiological methods of stone extraction. Clinicians are therefore confronted with a number of potentially valid options to diagnose and treat individuals with suspected CBDS. The British Society of Gastroenterology first published a guideline on the management of CBDS in 2008. Since then a number of developments in management have occurred along with further systematic reviews of the available evidence. The following recommendations reflect these changes and provide updated guidance to healthcare professionals who are involved in the care of adult patients with suspected or proven CBDS. It is not a protocol and the recommendations contained within should not replace individual clinical judgement.
authors.affiliation: Bournemouth Digestive Diseases Centre, Royal Bournemouth and Christchurch NHS Hospital Trust, Bournemouth, UK.
authors.forename: Earl
authors.initials: E
authors.lastname: Williams
authors.affiliation: HPB Service, Nottingham University Hospitals NHS Trust, Nottingham, UK.
authors.forename: Ian
authors.initials: I
authors.lastname: Beckingham
authors.affiliation: Bournemouth Digestive Diseases Centre, Royal Bournemouth and Christchurch NHS Hospital Trust, Bournemouth, UK.
authors.forename: Ghassan
authors.initials: G
authors.lastname: El Sayed
authors.affiliation: Department of Surgery, University College London Medical School, London, UK.
authors.forename: Kurinchi
authors.initials: K
authors.lastname: Gurusamy
authors.affiliation: Aintree Digestive Diseases Unit, Aintree University Hospital Liverpool, Liverpool, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Sturgess
authors.affiliation: Department of Hepatopancreatobiliary Medicine, University College Hospital, London, UK.
authors.forename: George
authors.initials: G
authors.lastname: Webster
authors.affiliation: Department of Radiology, The Princess of Wales Hospital, Bridgend, UK.
authors.forename: Tudor
authors.initials: T
authors.lastname: Young
mesh_terms: D000465:Algorithms; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D049448:Cholangiopancreatography, Magnetic Resonance; D002761:Cholangitis / Q000209:etiology / Q000628:therapy; D002763:Cholecystectomy; D019160:Endosonography; D042882:Gallstones / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery / Q000628:therapy*; D006801:Humans; D010535:Laparoscopy; D010195:Pancreatitis / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D016717:Sphincterotomy, Endoscopic; D015607:Stents
keywords: ACUTE PANCREATITIS; BILIARY OBSTRUCTION; ENDOSCOPIC RETROGRADE PANCREATOGRAPHY; GALLSTONE DISEASE; HEPATOBILIARY DISEASE