Common duct diameter as an independent predictor of choledocholithiasis: is it useful?
We have evaluated the value of ultrasonographic measurement of common duct diameter in isolation from other predictors of choledocholithiasis. A cohort of 223 patients who did not have a history of jaundice or pancreatitis and had normal liver function tests underwent pre-operative ultrasound of the common hepatic duct and then had elective (open) cholecystectomy with operative cholangiography. One hundred and ninety-one (86%) of all patients had a normal (< or = 5 mm) common duct and of these only 12 (6%) had common duct calculi. Of the 32 patients who had a common duct diameter greater than 5 mm on pre-operative ultrasonography, 12 (37.5%) patients had ductal calculi. A pre-operatively dilated duct on ultrasonography has a high chance of containing stones and should be considered as a strong indication for pre-operative bile duct imaging or operative cholangiography.
Majeed
A W
AW
Department of Surgical and Anaesthetic Sciences, University of Sheffield, UK.
Ross
B
B
Johnson
A G
AG
Reed
M W
MW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002763:Cholecystectomy; D005260:Female; D042882:Gallstones / Q000000981:diagnostic imaging*; D006500:Hepatic Duct, Common / Q000000981:diagnostic imaging*; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014463:Ultrasonography