Nursing Care for Patients with Common Bile Duct Stones Undergoing Endoscopic Retrograde Cholangiopancreatography: A Case Study

Abstract

Common bile duct stone is a common public health problem in Thailand. Patients often present with symptoms similar to gastrointestinal disorders such as intestinal or gastric diseases, making diagnosis challenging. Gallstones usually form in the gallbladder, and if left untreated, they may migrate into the bile duct, causing distal obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used for both diagnosis and treatment. It requires a relatively short duration, does not involve surgical incisions, but carries potential risks of complications. Therefore, nursing care plays a crucial role, requiring continuous and comprehensive assessment to ensure patient safety and support recovery to normal daily life.

Objective

To provide safe nursing care for patients with Common bile duct stone undergoing ERCP, preventing complications, and enabling patients to practice appropriate self-care both before and after the procedure as well as upon returning home.

Methods

This study employed a descriptive case study design involving one patient with Common bile duct stonetreated by ERCP between July 16–21, 2024, for a total of six days. Data were collected by the endoscopy unit nurse through medical history review and patient interviews. Nursing interventions were delivered across three stages: pre-procedure assessment and preparation, intra-procedure assistance during ERCP, and post-procedure follow-up. Telephone follow-ups were also conducted after hospital discharge. Patient and family education was provided regarding self-care at home and strategies to prevent recurrence of Common bile duct stone.

Results

The patient undergoing ERCP was safe, experienced no complications, and demonstrated the ability to perform self-care before and after the procedure, as well as at home following discharge. Subsequently, the patient underwent cholecystectomy to prevent recurrence of gallstones migrating into the bile duct.

Conclusion

Patients with Common bile duct stonewho undergo ERCP can achieve safe outcomes without complications and recurrence when provided with appropriate nursing care and education for effective self-management after discharge.