title: Choledochal distensibility at ERCP. A review of 70 ERCP examinations after cholecystectomy.
abstract: The maximal width of the extrahepatic biliary duct (EBDW) at ERCP was evaluated in 70 cholecystectomized patients. In all 27 patients in whom an obstructive lesions was confirmed, the maximal corrected choledochal width was larger than 10 mm. In the remaining 43 patients no actual obstructive lesions were found but in 29 of these cases the maximum diameter of the choledochus at ERCP exceeded 15 mm as measured on the film, which corresponds to a corrected diameter larger than 10 mm. The uncorrected maximal choledochal diameter in patients without actual obstruction was not correlated with the length of the interval between cholecystectomy and the ERCP examination, but it had a possible slight correlation with the age of the patients (p less than 0.05). There was no correlation with specific complaints, but all six patients with duodenobiliary reflux had an EBDW greater than 15 mm. A marked tendency towards diminution of the choledochal diameter was noted during emptying of the ducts, the diameter after emptying being closely correlated to the diameter noted at intravenous cholangiography in 15 patients (R = .958). This distensibility of the choledochus at ERCP should be taken into consideration when pathological choledochal duct dilatation is suspected.
mesh_terms: D000328:Adult; D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy / Q000009:adverse effects*; D003135:Common Bile Duct / Q000000981:diagnostic imaging*; D003137:Common Bile Duct Diseases / Q000000981:diagnostic imaging*; D004548:Elasticity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D013997:Time Factors