*Effect of Prophylactic CBD Stenting Versus Non Stenting on Recurrence of CBD Stones in Patients Awaiting Cholecystectomy*

Choledocholithiasis, the presence of stones in the common bile duct (CBD), occurs in 10-20% of patients with symptomatic gallstones and can lead to severe complications such as obstructive jaundice, cholangitis, and pancreatitis Endoscopic retrograde cholangiopancreatography (**ERCP**) with stone extraction is the gold standard treatment, achieving >90% success rates in ductal clearance.

Despite successful initial clearance, CBD stone recurrence remains a significant issue, with reported rates ranging from 4% to 24% .

To reduce recurrence, prophylactic biliary stenting has been proposed, particularly in high-risk patients (e.g., large or multiple stones, dilated CBD, periampullary diverticulum) However, its routine use remains controversial due to conflicting evidence on efficacy, stent-related complications (e.g., migration, occlusion, cholangitis), and increased healthcare costs.

"Inclusion Criteria":

• Age > 18 years.
• Documented CBD stones by various imaging or ERCP.
• Successful biliary clearance by ERCP.
• Scheduled for elective cholecystectomy within 3 months.
• Provide written informed consent.

"Exclusion Criteria":

• Previous biliary surgery.
• Known malignancy involving the biliary system.
• Comorbid conditions preventing surgery such as bleeding tendency.
• Pregnancy.
• Failure to obtain consent.
• Failed stone clearance.