title: Dilatation of the bile duct in patients after cholecystectomy: a retrospective study.
abstract: OBJECTIVE
  Retrospective assessment of impact of cholecystectomy, age, and sex on bile duct (BD) diameter.
  
  
  METHODS
  We retrospectively reviewed abdominal contrast-enhanced multidetector computed tomography and laboratory reports of 290 consecutive patients (119 men; mean age, 55.9 years) who presented without cholestasis to the emergency department of our institution between June 2009 and August 2010. BD diameters were measured in 3 locations, by 2 independent observers, twice, at 1-month intervals. Reproducibility and agreement were evaluated by intraclass correlation coefficients and Bland-Altman analyses. The effects of cholecystectomy, age, and sex on BD diameter were analysed with linear mixed models.
  
  
  RESULTS
  BD diameter inter-reader reproducibility and agreement were excellent at the level of the right hepatic artery (intraclass correlation coefficient, 0.94). Sixty-one patients (21.0%) had a history of cholecystectomy. Among them, the 95th percentile of BD diameters at hepatic artery level was 7.9 mm (<50 years) and 12.3 mm (≥50 years). Among those without cholecystectomy, BD diameter was 6.2 mm (<50 years) and 7.7 mm (≥50 years). Cholecystectomy was associated with significantly larger BD diameters in both age groups (P < .001). Older age was associated with larger BD diameters (P = .004). Sex had no impact on BD diameter (P = .842).
  
  
  CONCLUSIONS
  Patients after cholecystectomy may present with an enlarged BD unrelated to cholestasis. The BD diameter increases with age. Clinicians should rely on cholecystectomy status, age, and laboratory results to determine needs of further investigation.
authors: Department of Radiology, University of Montréal and CRCHUM, Hôpital Saint-Luc, Montréal, Québec, Canada.
authors: David
authors: D
authors: Landry
authors: Department of Radiology, University of Montréal and CRCHUM, Hôpital Saint-Luc, Montréal, Québec, Canada.
authors: An
authors: A
authors: Tang
authors: Department of Radiology, University of Montréal and CRCHUM, Hôpital Saint-Luc, Montréal, Québec, Canada. Electronic address: jessica.murphy-lavallee.chum@ssss.gouv.qc.ca.
authors: Jessica
authors: J
authors: Murphy-Lavallée
authors: Department of Radiology, University of Montréal and CRCHUM, Hôpital Saint-Luc, Montréal, Québec, Canada.
authors: Luigi
authors: L
authors: Lepanto
authors: Department of Radiology, University of Montréal and CRCHUM, Hôpital Saint-Luc, Montréal, Québec, Canada.
authors: Jean-Sébastien
authors: JS
authors: Billiard
authors: Department of Radiology, University of Montréal and CRCHUM, Hôpital Saint-Luc, Montréal, Québec, Canada.
authors: Damien
authors: D
authors: Olivié
authors: Biostatistics Services, University of Montreal Hospital Research Center (CRCHUM), Centre de recherche du CHUM, Montréal, Québec, Canada.
authors: Marie-Pierre
authors: MP
authors: Sylvestre
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001649:Bile Duct Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D002758:Cholangiography / Q000379:methods*; D002763:Cholecystectomy / Q000009:adverse effects*; D003287:Contrast Media; D004108:Dilatation, Pathologic / Q000000981:diagnostic imaging / Q000209:etiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007472:Iohexol; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012737:Sex Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol
keywords: Bile duct; Cholecystectomy; Cholestasis; Dilatation