title: Dynamic changes in the common bile duct after laparoscopic cholecystectomy: a prospective longitudinal sonographic study.
abstract: OBJECTIVE
  The aim of this prospective study was to assess the dynamics of potential common bile duct (CBD) dilatation and to find the best predictors in patients after laparoscopic cholecystectomy due to gallstones.
  
  
  METHODS
  Fifty patients (36 women, 14 men) with gallstones scheduled for laparoscopic cholecystectomy underwent preoperative sonography one day prior to surgery and again within 24 hours of cholecystectomy. In all patients, the diameter of the CBD was measured again on the 7 (th), 90 (th) and 180 (th) day after cholecystectomy. The luminal diameter was measured just below the bifurcation of hepatic ducts, at the level of intersection with the hepatic artery and at the level of the pancreatic head. The control group consisted of 50 healthy individuals (35 women and 15 men) with normal biochemistry and sonography, and without a history of hepatobiliary disease, clinical symptoms or surgery.
  
  
  RESULTS
  The mean preoperative CBD diameter at three locations was 2.27 ± 0.18, 3.49 ± 0.23 and 4.31 ± 0.30, respectively. The mean diameter of the common bile duct measured within 24 hours of surgery and on the seventh postoperative day did not significantly change with respect to the preoperative measurement. Three months after cholecystectomy, the CBD was statistically wider at all three locations (p < 0.05). Six months after cholecystectomy, the CBD remained significantly wider at the proximal and distal part when compared to the preoperative measurements.
  
  
  CONCLUSIONS
  The CBD showed an overall trend towards a slight, but significant, dilatation after cholecystectomy. The common bile duct dilates significantly 3 months after cholecystectomy. Familiarity with these patterns prevents ultrasound misdiagnosis when examining patients within 6 months of cholecystectomy.
authors.affiliation: Radiology, Clinical Hospital Center Rijeka. petra.valkovic@ri.t-com.hr
authors.forename: P
authors.initials: P
authors.lastname: Valkovic
authors.forename: D
authors.initials: D
authors.lastname: Miletic
authors.forename: M
authors.initials: M
authors.lastname: Zelic
authors.forename: B
authors.initials: B
authors.lastname: Brkljacic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017081:Cholecystectomy, Laparoscopic; D003135:Common Bile Duct / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D012016:Reference Values; D014463:Ultrasonography; D055815:Young Adult