Evaluation of effect of cholecystectomy on common bile duct diameter using ultrasonography and liver function test: a prospective study
DOI:
https://doi.org/10.18203/2349-2902.isj20181103Keywords:
Cholecystectomy, CBD diameter, USG AbdomenAbstract
Background:Different factors influencing the post cholecystectomy CBD diameter have been implicated. Ultrasound has emerged as a diagnostic imaging method of choice for liver and extrahepatic biliary system. In order to differentiate the diagnosis of asymptomatic bile duct dilatation, one needs to perform either MRCP or ERCP, which are both expensive and/or invasive test. Therefore, it is necessary to understand the physiological changes in bile duct after cholecystectomy to reduce unnecessary testing for early detection of bile duct lesions.
Methods: 100 cases of gall stone disease undergoing cholecystectomy in the department of surgery were studied. Pre operative and Post operative Ultrasound whole abdomen with focus on CBD diameter and Liver function test were done, Post operative data was collected on 10th day and again after 3 months. The data was compiled, compared and analysed.
Results:The mean preoperative diameter was 4.12 mm, postoperatively, the mean diameter of the CBD in early follow up period i.e. at 10th day and at 3 months, was found to be 4.75 and 5.14 mm respectively. The difference between mean preoperative and mean postoperative (10th day follow up) diameter was found to be 0.63 mm (p<0.01). The difference between mean preoperative and mean postoperative (3 months follow up) diameter was found to be 1.02 (p<0.01) mm, both statistically significant.
Conclusions:Significant compensatory dilatation does occur in common bile duct diameter after cholecystectomy in most of the patients.
References
DeVita, Vincent T. Lawrence, Theodore S. Preface. In: DeVita, Vincent T. Lawrence, Theodore S, eds. Principles and Practice of Oncology. 8th Ed. US: CBSPD;2008.
Nahrwold DL. Historical aspects The biliary system Sabistan Textbook of Surgery,14th ed. 1991:1042.
Siegel MJ. Liver and biliary tract. In: Pediatric Sonography. Siegel MJ, eds. New York, NY, USA: Raven Press; 1995:171.
Park SM, Kim WS, Bae IH, Kim JH, Ryu DH, Jang LC et al. Common bile duct dilatation after cholecystectomy: a one-year prospective study. J Korean Surg Soc. Aug;83(2):97-101.
Järvinen H. Abnormal liver function tests in acute cholecystitis; the predicting of common duct stones. Ann Clin Res. 1978;10(6):323-7.
Qvist. The influence of cholecystectomy on the normal Common bile duct. Acta Chir Scandinav. 1957;113:30.
Sandweiss DJ, Fulton H. Intravenous cholangiography. JAMA. 1955;159:998-1001.
Don C, Campbell H. J Pac Radiol (Lond) 7:197,1956. Quoted by Quesne. 1956.
Wise RE, Johnston DC and Salzman FA. The intravenous cholangiographic diagnosis of partial obstruction of the common bile duct. Radiology. 1957;68:507.
Quesne LE and Whiteside CG. The common bile duct after cholecystectomy. Brit Med J. 1959;329.
Longo MF, Ferris DO and Hodgson JR. Size of the common bile duct following cholecystectomy. Annal Surg. 1967;165:250-3.
Edmunds R, Katz S, Garciano V and Finby N. The common duct after cholecystectomy. Arch Surg. 1971;103:79-81.
Graham MF, Cooperberg PL, cohen MM and Burhenne HJ. The size of the normal common hepatic duct following cholecystectomy: An ultrasonographic study. Radiology. 1980;135:137-9.
Mueller PR, Ferucci JT, Simeone JF, Wittenberg J and Polansky A. Post –cholecystectomy bile duct dilatation: Myth or Reality? AJR. 1981;136:355-8.
Kaude JV. The width of the common bile duct in relation to age and stone disease. An ultrasonographic study. Eur J Radiol. 1983;3(2):115-7.
Niederau C, Mueller J, Sonnenberg A. Extrahepatic bile ducts in healthy subjects, in patients with cholelithiasis, and in post-cholecystectomy patients. A prospective ultrasonic study. J clin ultrasound 1983;11:23.
Co CS, Shea WJ and Goldberg HI. Evaluation of common bile duct diameter using high resolution computed tomography. J Comp Assist Tomograp. 1986:424-7.
Chung SCS, Leung JWC and Li ARC. Bile duct size after cholecystectomy: an endoscopic retrograde cholangioopancreatographic study. Br J Surg. 1990;77:534-535.
Hunt DR and Scott AJ. Changes in bile duct diameter after cholecystectomy: A 5-year prospective study. Gastroenterology. 1989;97:1485-8.
Farrell TA, Geraghty JG and Kelling F. Abdominal ultrasonography following laproscopic cholecystectomy: A prospective study. Clin Radiol. 1993;47:111-3.
Bucceri AM, Brogna A, Ferrara R. Common bile duct caliber following cholecystectomy, A two-year sonographic survey. Abdominal Imaging. 1994;19:251-2.
Feng B, Song Q. Does the common bile duct dilate after cholecystectomy. Sonographic evaluation in 234 patients. AJR. 1995;165:859-61.
Hammarstorm LE, Holmin T, Ebbesen A and Stridbeck H. Influence of cholecystectomy on bile duct width. Br J Surg. 1957;83:1706-8.
Cooperberg PL. High-resolution real time ultrasound in the evaluation of normal and obstructed biliary tract. Radiology. 1978;129:477-80.
Parulekar SG. Ultrasound evaluation of common bile duct size. Radiology. 1979;133:703-7.
Wedmann B, Borsch G, Coenen C, Paassen A. Effect of cholecystectomy on common bile duct diameters: A longitudinal prospective ultrasonographic study. J Clin Ultrasound. 1988;16:619-24.
Chopra S, Griffin PH. Labroatory tests and diagnostic procedures in evalution of liver disease. Am J Med. 1985;79:221-4.
