CBD Stones (Choledocholithiasis)

Bile is the digestive fluid produced by the liver and stored in the gallbladder. When you eat, the bile is emptied through the bile duct into the small intestine to aid digestion. Gallstones form if your bile contains excessive cholesterol, too much bilirubin, or insufficient bile salts. Such imbalances are caused by certain risk factors including:

• Unbalanced/ fatty/ low-fibre diet
• Family history
• Advanced age (over 40 years)
• Sedentary lifestyle
• Diabetes
• Liver disease
• Losing weight too quickly
• Pregnancy
• Certain medications

Yes, CBD stones are highly curable. Through a combination of medications, endoscopic techniques such as ERCP, EUS, and SpyGlass Cholangioscopy, and laparoscopic surgery, it is possible to remove gallstones, ensure pain relief, and prevent formation of future stones. Dr. Rajiv Grover, an advanced endoscopy specialist in Ludhiana, is widely known for his use of SpyGlass Cholangioscopy to treat CBD stones and ensure immediate pain relief to patients.

Yes, CBD stones are serious even though may may not always cause problems. They are particularly considered a medical priority when they get lodged in the bile duct and/or grow overtime in the CBD, causing a blockage to the flow of bile. In either case, they warrant immediate medical attention. If left untreated, this could lead to severe digestive crisis, infection, jaundice, and pancreatitis.

If you notice any of these warning signs, you must seek immediate medical help:

• Persistent, intense abdominal pain
• Severe pain that makes sitting difficult
• Jaundice
• High fever with chills
• Rapid heartbeat
• Low blood pressure

While a standard ERCP (Endoscopic Retrograde Cholangiopancreatography) uses X-ray shadows to guess the location of a stone or blockage, SpyGlass Cholangioscopy allows the doctor to actually see inside your bile ducts in high definition.

• Direct Visualization: It uses a tiny, spy camera – about the size of a pencil lead – that is inserted directly into the bile or pancreatic ducts.  
• Precision Stone Breaking: For stones that are too large or stuck to be removed by traditional ERCP, specialists like Dr. Rajiv Grover use the SpyGlass to perform Laser or Electrohydraulic Lithotripsy, breaking the stone into tiny fragments under direct vision.
• Accurate Biopsies: If there is a suspicious growth or narrowing (stricture), SpyGlass allows for a targeted biopsy, ensuring the tissue sample is taken from the exact spot needed for a 100% accurate diagnosis.

While oral medications do exist for dissolving small cholesterol stones, the process takes months and even years. These stones often return after the medication course has stopped. Advanced endoscopic interventions and cholecystectomy are preferred methods to treat CBD stones.

Dr. Rajiv Grover leverages his sharp clinical acumen, modern medical protocols, and advanced techniques for the removal of gallbladder and CBD stones and prevention of future stone formation. He is a highly regarded ERCP specialist in Ludhiana and a regional authority in the use of advanced endoscopic techniques such as ERCP, MRCP, EUS, and SpyGlass Cholangioscopy for the location and removal of obstructive gallstones. He individualizes the treatment plan based on the location and severity of gallstones and may include a combination of medical treatments, endoscopic techniques, laparoscopic interventions, biliary drainage, lifestyle optimization and nutritional support.