A prospective study to determine the effect of cholecystectomy on common bile duct diameter in Indian population

Background and Aim: Though increase in the common bile duct (CBD) diameter has been attributed to previous cholecystectomy, this relationship continues to be controversial. Our objective was to evaluate the relationship between cholecystectomy and change in CBD diameter, as measured by ultrasonography. Methods: A total of 50 cases (age, 44.0 ± 12.4 years; men, 8; women, 42) were admitted with symptomatic cholelithiasis and normal bile duct diameters. They underwent cholecystectomy, and the CBD diameter was measured by single diagnostician using ultrasonography at the widest point after full-length evaluation of CBD. Follow-up ultrasound at 2 months and 4 months postoperatively was done in all cases. Results: Mean preoperative CBD diameter observed was 5.12 ± 0.97 mm and mean postoperative CBD diameter observed at 2 months and 4 months interval were 6.79 ± 1.23 mm (32.61% increase; P < 0.0001) and 7.1 ± 1.28 mm (38.47% increase; P < 0.001), respectively. There was a rise in number of patients with CBD diameter of >6.5 mm from nil to 19 (38%) and 25 (50%) at 2 months and 4 months, respectively. CBD dilatation was observed to be age-dependent with mean postoperative diameter increase of 3.37 mm in patients with age >50 years. Conclusion: The present study confirms that the CBD dilates significantly after cholecystectomy. The postcholecystectomy, CBD diameter does not exceed 10 mm. Thus, a wider CBD following cholecystectomy may warrant further investigation to know the etiology.

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