Dilated common bile duct in opium addicts with and without biliary symptoms --implication for research in AIDS cholangiopathy.
BACKGROUND
Opium addicts (OA) with no biliary symptoms have been shown to have dilated common bile duct (CBD). Endoscopic retrograde cholangio-pancreatography (ERCP) without biliary drainage in such asymptomatic OA is hazardous. Hence it is not indicated unless there are clear clinical and laboratory evidences of biliary stasis.


OBJECTIVE
To show that even when matched with controls with the same clinical diagnosis of the biliary system, OA still have significantly larger CBD diameters and that OA with biliary symptoms should be treated no differently from non-OA with biliary symptoms.


METHODS
Seven OA (all Chinese males), four of whom had undergone ERCP (three for CBD stones and one for ampullary carcinoma), were compared, using t-test, to 7 age, sex, race and diagnosis-matched controls, four of whom had also undergone ERCP (three for CBD stones and one for ampullary carcinoma). When ERCP was not done, ultrasonography was used to assess the biliary system and measure the CBD diameter.


RESULTS
The mean (SD) CBD diameters of OA and controls were 15.7 mm (5.65) and 8.3 mm (5.95) respectively (t = 2.399, p = 0.032). The mean (SD) weight of OA and controls were 55.8 kg (9.22) and 57.3 kg (9.21) respectively (t = -0.305, p = 0.763). Only two of the seven OA were born in China, the remaining five in Malaysia.


CONCLUSIONS
OA do get CBD pathology like non-OA and if indicated there should be no qualms about performing ERCP in them. When matched for age, sex, race and clinical diagnosis, OA still have a significantly larger CBD despite no difference in body weight.
D000163:Acquired Immunodeficiency Syndrome / Q000473:pathology / Q000635:transmission; D000368:Aged; D001660:Biliary Tract Diseases / Q000139:chemically induced* / Q000175:diagnosis*; D016022:Case-Control Studies; D002681:China; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003135:Common Bile Duct / Q000473:pathology*; D000075202:Contraindications; D006801:Humans; D008297:Male; D008875:Middle Aged; D009892:Opium; D011446:Prospective Studies; D019966:Substance-Related Disorders / Q000150:complications*
D009892:Opium