Caliber of the common bile duct: effect of cholecystectomy and other factors in a ultrasonographic study of 8534 patients

Abstract

Objective: The objective of the present study was to analyze the effects of different factors impacting the caliber of the common bile duct (CBD) and a comparison of maximum extrahepatic bile duct caliber in patients with and without a history of cholecystectomy.

Material and Methods: A retrospective data analysis was undertaken of 8534 patients (4480 females; 4054 males; average age: 59.2 ± 18.0 years) with sonographic documentation of bile duct caliber. Maximum intra- and extrahepatic bile duct diameters were studied. The normal maximum diameter of the extrahepatic bile duct was defined as 7 mm. In patients who had undergone prior cholecystectomy, a maximum bile duct diameter < 10 mm was considered normal.

Results: The average maximum diameter of the CBD amounted to 5.3 ± 3.0 mm for the overall collective. In patients who had undergone prior cholecystectomy, maximum CBD diameters in the normal range (< 7 mm) were documented in 55 %, while larger diameters (> 7 mm) were observed in 45 %. In the collective of patients without prior cholecystectomy, CBD diameters in the normal range (< 7 mm) were found in 81 %, with larger diameters observed in only 18.4 % of patients. In both subgroups, there was a significant association between age and bile duct diameter (for those with prior cholecystectomy, p = 0.0003; without prior cholecystectomy, p < 0.0001). No statistically significant influence on CBD diameter was observed for either prior cholecystectomy (p = 0.2116) or time interval since cholecystectomy (p = 0.3537). Females, both with and without a history of prior cholecystectomy, showed a 1.4 – 1.5-fold higher risk of exhibiting a CBD diameter > 7 mm (for those with prior cholecystectomy, p = 0.0485; without prior cholecystectomy, p < 0.001).

Conclusions: Our data show a positive correlation between age and CBD diameter. There was no statistically significant relationship between CBD diameter and prior cholecystectomy, postoperative interval and BMI.

Zusammenfassung

Ziel: Ziel der vorliegenden Arbeit war die Analyse verschiedener Einflussfaktoren auf die Weite des Ductus hepatocholedochus (DHC-Weite) und der Vergleich der maximalen extrahepatischen Gallengangsweite bei cholezystektomierten und nicht-cholezystektomierten Patienten.

Material und Methoden: Retrospektive Datenanalyse von 8534 Patienten (Frauen: n = 4480; Männer: n = 4054, durchschnittliches Alter 59,2 ± 18,0 Jahre), deren Weite des Gallengangs sonografisch dokumentiert wurde. Untersucht wurden die maximale intra- und extrahepatische Gallengangsweite. Der Normwert für die maximale extrahepatische Gallengangsweite wurde mit 7 mm definiert. Bei Patienten mit Zustand nach Cholezystektomie galt eine Gallengangsweite < 10 mm als normwertig.

Ergebnisse: Im Gesamtkollektiv lag die mittlere Gallengangsweite bei 5,3 ± 3 mm. Bei 55 % der cholezystektomierten Patienten war die DHC-Weite normwertig (< 7 mm), bei 45 % oberhalb des Normbereichs (> 7 mm). Im Kollektiv der nicht-cholezystektomierten Patienten lag in 81 % die DHC-Weite im Normbereich (< 7 mm), bei 18,4 % darüber. In beiden Subgruppen zeigte sich eine signifikante Assoziation zwischen Alter und Gallengangsweite (p-Wert der Cholezystektomierten = 0,0003, p-Wert der Nicht-Cholezystektomierten < 0,0001). Weder der Zustand nach Cholezystektomie (p = 0,2116) noch das Zeitintervall nach der Operation (p = 0,3537) zeigten einen Einfluss auf die DHC-Weite. In der Gruppe der nicht-cholezystektomierten und cholezystektomierten Patienten zeigten Frauen ein 1,4- bis 1,5-fach höheres Risiko hinsichtlich einer DHC-Weite > 7 mm (p-Wert der Cholezystektomierten = 0,0485, p-Wert der Nicht-Cholezystektomierten < 0,001).

Schlussfolgerungen: Unsere Ergebnisse zeigen eine positive Korrelation zwischen Alter und DHC-Weite. Hinsichtlich der Einflussfaktoren Cholezystektomie, postoperatives Zeitintervall und BMI besteht kein statistischer Zusammenhang mit der DHC-Weite.

Schlüsselwörter

Ductus hepatocholedochus - Alter - Choleczystektomie - Ultraschall

Key words

common bile duct - age - cholecystectomy - ultrasound

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