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

Abstract

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.