Does the common bile duct dilate after cholecystectomy? Sonographic evaluation in 234 patients.

OBJECTIVE: The purpose of this study was to determine whether the common bile duct dilates after cholecystectomy.

SUBJECTS AND METHODS: All 234 patients who had cholecystectomy at our hospital between October 1985 and April 1994 were included in this study. The luminal diameter of the proximal segment of the common bile duct was measured on antero-posterior transverse sonograms 4-15 days before cholecystectomy. In all patients, the luminal diameter was measured again on sonograms obtained 7-2160 days after surgery (mean, 393 days; median, 180 days; mode, 360 days). A diameter of 6 mm or less was considered normal. This study contained 197 patients with a normal common bile duct (< or = 6 mm) and 37 patients with a dilated common bile duct (> 6 mm).

RESULTS: The mean diameter of the common bile duct measured on sonograms was 5.9 mm before cholecystectomy and 6.1 mm after cholecystectomy. This difference was statistically significant (p < .05). The diameter of the common bile duct increased in 110 patients, decreased in 61 patients, and stayed the same in 63 patients. Of the 234 patients, 197 (84%) had a normal preoperative diameter of the common bile duct, whereas 167 (71%) had a common bile duct with a normal diameter postoperatively.

CONCLUSION: The diameters of the common bile duct as measured on sonograms increase slightly after cholecystectomy. Most patients do not have significant compensatory dilatation of the duct after cholecystectomy.