The preoperatively normal bile duct does not dilate after cholecystectomy: results of a five year study

BACKGROUND The common hepatic duct (CHD) is commonly believed to dilate after cholecystectomy but previous studies have either not measured CHD diameter preoperatively or the follow up period is short. AIMS To measure CHD diameter before and after cholecystectomy. METHODS Patients undergoing (open) cholecystectomy and operative cholangiography had ultrasonographic measurement of CHD diameter before, and three and six months, and one and five years after cholecystectomy. The normal duct diameter was considered to be 5 mm or less, with an observer error of ±1 mm. RESULTS Fifty nine patients with normal diameter ducts were studied. The majority (more than 95%) of patients did not have a dilatation of the CHD beyond 6 mm after cholecystectomy. The CHD appeared to increase as well as decrease with an overall trend towards a minor increase at five years. This was not statistically significant if the margin of error of 1 mm was taken into account. CONCLUSION A preoperatively normal CHD does not dilate after cholecystectomy and may require further investigation in symptomatic patients.

[1]  L. Hammarström,et al.  Is there a significant increase in bile duct width after cholecystectomy? , 1997, Scandinavian journal of gastroenterology.

[2]  L. Hammarström,et al.  Routine preoperative infusion cholangiography at elective cholecystectomy: A prospective study in 694 patients , 1996, The British journal of surgery.

[3]  A. Crozier,et al.  Biliary distensibility during per-operative cholangiography as compared to pre-operative ultrasound: a four year follow-up study. , 1996, Clinical Radiology.

[4]  R. Wachsberg.  Respiratory variation of extrahepatic bile duct diameter during ultrasonography. , 1994, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[5]  D. Hunt,et al.  Changes in bile duct diameter after cholecystectomy: a 5-year prospective study. , 1989, Gastroenterology.

[6]  Chung‐Chieng Wu,et al.  Effect of aging on common bile duct diameter: A real‐time ultrasonographic study , 1984, Journal of clinical ultrasound : JCU.

[7]  A. Sonnenberg,et al.  Comparison of the extrahepatic bile duct size measured by ultrasound and by different radiographic methods , 1984 .

[8]  W. Ruddell,et al.  Endoscopic retrograde cholangiograms of the normal and post‐cholecystectomy biliary tree , 1982, The British journal of surgery.

[9]  J. Wittenberg,et al.  Observations on the distensibility of the common bile duct. , 1982, Radiology.

[10]  J. Bruneton,et al.  Ultrasound evaluation of common bile duct size in normal adult patients and following cholecystectomy. A report of 750 cases. , 1981, European journal of radiology.

[11]  P. Cooperberg,et al.  The discrepancy between radiographic and sonographic bile-duct measurements. , 1980, Radiology.

[12]  S G Parulekar,et al.  Ultrasound evaluation of common bile duct size. , 1979, Radiology.

[13]  K. Wakim,et al.  The Common Bile Duct in Man: Its Diameter and Circumference , 1967, Annals of surgery.

[14]  J. Hughes,et al.  The Common Duct After Cholecystectomy: Initial Report of a Ten-Year Study , 1966 .

[15]  P. Edholm,et al.  Bile duct stones related to age and duct width. , 1962, Acta chirurgica Scandinavica.

[16]  A. Sonnenberg,et al.  Comparison of the extrahepatic bile duct size measured by ultrasound and by different radiographic methods. , 1984, Gastroenterology.

[17]  R. B. Morrison,et al.  THE RELATIONSHIP OF CHOLECYSTITIS AND CHOLECYSTECTOMY TO DILATATION OF THE CHOLEDOCHUS. , 1935, Annals of surgery.