Abstract:
Backgrounds/Aims: Published data on choledocholithiasis in Sri Lanka is scarce. This study was conducted to determine epidemiological, clinical and endoscopic characteristics of choledocholithiasis in Sri Lanka. Methods: This was
a retrospective study of consecutive patients for a period of three years until April 2016. The sample included patients
from many parts of the island. Patients were selected from the endoscopy database of the unit and the data were
collected from the records of the patients. Results: A total of 253 patients were included in the study. The mean age
of the patients was 53.6 years. Patients presented with obstructive jaundice (58.5%), cholangitis (25.3%), biliary colic
or upper abdominal pain (14.2%) and acute biliary pancreatitis (1.8%). There were 26 (10.3%) post cholecystectomy
patients. Concomitant gallbladder stones were found in 173 patients (68.4%). Juxta-papillary diverticula were found
in 36 patients (14.2%). Twenty-one (8.3%) and nine patients (3.6%) were found to have choledochal cysts and common
bile duct strictures, respectively. Stones were commonly found in the distal common bile duct (68.4%). A majority of
the patients had a single stone (47.8%). In 209 patients (79.6%), the size of the largest stones measured between
0.5-1.5 cm. Conclusions: Choledocholithiasis is a disease affecting middle-aged population with predominance among
females in Sri Lanka. Patients with symptomatic choledocholithiasis commonly present with obstructive jaundice. In
the present study, most of the stones were formed in anatomically normal biliary systems. Stones were predominantly
distal, single and measured 0.5-1.5 cm in size. The observed features were favorable features for successful endoscopic clearance. None of the patients included in the study had primary CBD stones according to the available criteria
