Professional and Linguistic Assessments Board (PLAB) Practice Exam

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What procedure is indicated for gallstones in the common bile duct?

Cholecystectomy
ERCP
Lap chole
Stenting

The correct answer is: Lap chole

The appropriate procedure indicated for gallstones in the common bile duct is endoscopic retrograde cholangiopancreatography, commonly known as ERCP. This procedure is particularly effective for diagnosing and treating issues within the bile ducts, including gallstones that may be causing obstruction. ERCP involves the use of endoscopy to access the duodenum and the bile duct, allowing for both visualization and intervention. If gallstones are identified in the common bile duct during this procedure, they can often be removed using techniques such as balloon sweep or basket retrieval. In contrast, cholecystectomy and lap chole refer to the surgical removal of the gallbladder, which may be performed to prevent future episodes of biliary colic or pancreatitis caused by gallstones, but they do not directly address stones already lodged in the common bile duct. Stenting can be indicated in certain cases to relieve obstruction, but it is not a primary procedure for the removal of gallstones. Understanding the specific role of ERCP is essential for effectively managing patients with biliary complications due to gallstones.