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Abdominal Radiology

, Volume 42, Issue 5, pp 1408–1414 | Cite as

Mild asymptomatic intrahepatic biliary dilation after cholecystectomy, a common incidental variant

  • Christopher J. Atkinson
  • Christopher J. Lisanti
  • Ryan B. Schwope
  • Daniel Ramsey
  • Timothy Dinh
  • Allyson Cochet
  • Michael J. Reiter
Article

Abstract

Objective

The purpose of this study is to evaluate the prevalence of intra- and extrahepatic ductal dilatation in asymptomatic individuals after cholecystectomy.

Methods and materials

This IRB-approved retrospective cohort study evaluated the prevalence of intra- and extrahepatic biliary dilation in 77 consecutive post cholecystectomy patients who had CT obtained in the portal venous phase. These were then compared to age and sex matched control patients. Two radiologists in consensus blinded to surgical history evaluated the intrahepatic ducts qualitatively for dilatation. A single radiologist using the best of three orthogonal planes measured the extrahepatic ducts. Extrahepatic ducts were considered dilated if >7 mm plus 1 mm/decade after 60 years. T tests and chi-squared tests were performed.

Results

Cholecystectomy patient duct patterns: normal ducts 26% (20/77); intra- and extrahepatic dilation 31.2% (24/77); intrahepatic dilation only 18.2% (14/77); extrahepatic dilation only 24.7% (19/77). Control patient duct patterns: normal ducts 88.3% (68/77); intra- and extrahepatic dilation 2.6% (2/77); intrahepatic dilation only 2.6% (2/77); extrahepatic dilation only 6.5% (5/77). All intrahepatic ductal dilatation was mild. Total intrahepatic dilation: 49.4% (cholecystectomy); 5.2% (control patients). The relative risk of intrahepatic ductal dilation in cholecystectomy patients was 9.5:1. Increased prevalence of intra- and extrahepatic dilation in cholecystectomy patients was statistically significant (p < 0.0001). Average extrahepatic duct was 7.8 mm (cholecystectomy) and 5.3 mm (control patients) (p < 0.001).

Conclusion

Mild intrahepatic biliary dilation in the setting of cholecystectomy is very common, and if not associated with clinical or biochemical evidence of obstruction is likely of no clinical significance.

Keywords

Intrahepatic Cholecystectomy Biliary Dilatation 

Notes

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

Dr. Lisanti receives royalties from Lippincott William-Wilkins for the book MRI: The Basics. The other authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

Statement of informed consent was not applicable since the manuscript does not contain any patient data.

Disclaimer

The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, and Department of Defense or the U.S. Government.

References

  1. 1.
    Oddi R (1887) D’une disposition a sphincter speciale de l’ouverture du canal choledoque. Arch Ital Biol 8:317–322Google Scholar
  2. 2.
    McArthur TA, Planz V, Fineberg NS, et al. (2015) CT evaluation of common duct dilation after cholecystectomy and with advancing age. Abdom Imaging 40:1581–1586CrossRefGoogle Scholar
  3. 3.
    McArthur TA, Planz V, Fineberg NS, et al. (2015) The common duct dilates after cholecystectomy and with advancing age: reality or myth? J Ultrasound Med 32(8):1385–1391CrossRefGoogle Scholar
  4. 4.
    Park SM, Kim WS, Bae I, et al. (2012) Common bile duct dilatation after cholecystectomy: a one-year prospective study. J Korean Surg Soc 83(2):97–101CrossRefGoogle Scholar
  5. 5.
    Valkovic P, Miletic D, Zelic M, Brkljacic B (2011) Dynamic changes in the common bile duct after laparoscopic cholecystectomy: a prospective longitudinal sonographic study. Ultraschall Med 32:479–484CrossRefGoogle Scholar
  6. 6.
    Peng R, Zhang L, Zhang X, et al. (2015) Common bile duct diameter in an asymptomatic population: a magnetic resonance imaging study. World J Radiol 7(12):501–508CrossRefGoogle Scholar
  7. 7.
    Feng B, Song Q (1995) Does the common bile duct dilate after cholecystectomy? Sonographic evaluation in 234 patients. AJR 165(4):859–861CrossRefGoogle Scholar
  8. 8.
    Senturk S, Miroglu TC, Bilici A, et al. (2012) Diameters of the common bile duct in adults and postcholecystectomy patients: a study with 64-slice CT. Eur J Radiol 81:39–42CrossRefGoogle Scholar
  9. 9.
    Daradkeh S, Tarawneh E, Al-Hadidy A (2005) Factors affecting common bile duct diameter. Hepatogastroenterology 52:1659–1661PubMedGoogle Scholar
  10. 10.
    Brant W (2012) Liver, biliary tree and gallbladder. In: Brant W, Helms C (eds) Fundamental of Diagnostic Radiology. Philadelphia: Lippincott Williams and Wilkins, pp 710–717Google Scholar
  11. 11.
    Raptopoulos V, Fabian TM, Silva W, et al. (1985) The effect of time and cholecystectomy on experimental biliary tree dilatation. A multi-imaging evaluation. Invest Radiol 20(3):276–286CrossRefGoogle Scholar
  12. 12.
    Raparia K, Zhai QJ, Schwartz MR, et al. (2010) Muscularis mucosae versus muscularis propria in gallbladder, cystic duct, and common bile duct: smoothelin and desmin immunohistochemical study. Ann Diagn Pathol 14(6):408–412CrossRefGoogle Scholar
  13. 13.
    Laing F (1998) The gallbladder and bile ducts. In: Rumack CM, Wilson SR, Charboneau JW (eds) Diagnostic Ultrasound Vol. 1. St Louis: Mosby-Year Book, pp 175–223Google Scholar
  14. 14.
    Rubens D (2007) Ultrasound imaging of the biliary tract. Ultrasound Clin 2:391–413CrossRefGoogle Scholar
  15. 15.
    Coss A, Enns R (2009) The investigation of unexplained biliary dilatation. Curr Gastroenterol Rep 11(2):155–159CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York (outside the USA) 2017

Authors and Affiliations

  • Christopher J. Atkinson
    • 1
  • Christopher J. Lisanti
    • 1
    • 2
  • Ryan B. Schwope
    • 1
    • 2
  • Daniel Ramsey
    • 1
  • Timothy Dinh
    • 1
  • Allyson Cochet
    • 3
  • Michael J. Reiter
    • 4
  1. 1.Department of RadiologySan Antonio Military Medical CenterFt Sam HoustonUSA
  2. 2.Department of RadiologyUniformed Services University of the Health SciencesBethesdaUSA
  3. 3.Department of GastroenterologySan Antonio Military Medical CenterFt Sam HoustonUSA
  4. 4.Department of RadiologyStony Brook University Medical CenterStony BrookUSA

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