Effect of the diameter of the common bile duct on the incidence of bile duct stones in patients with recurrent attacks of right epigastric pain after cholecystectomy.

OBJECTIVE

To study the relationship between the diameter of the common bile duct and the incidence of bile duct stones in non-jaundiced patients with recurrent attacks of right epigastric pain after cholecystectomy.

DESIGN

Retrospective study.

SETTING

University hospital, Finland.

SUBJECTS

57 consecutive, non-jaundiced patients admitted for elective endoscopic retrograde cholangiopancreatography (ERCP) because of attacks of right epigastric pain after cholecystectomy.

INTERVENTIONS

Measurement of maximum diameter of the common bile duct and presence or absence of bile duct stones.

MAIN OUTCOME MEASURES

Diameter of bile duct (10 mm or less was regarded as normal) and presence or absence of stones.

RESULTS

33 patients had normal-sized bile ducts and in 24 they were widened. Only 2/33 patients with normal-sized ducts (6%) had stones, compared with 11/24 (46%) with wide ducts (p = 0.0008). However, the degree of ductal dilatation did not seem to have any influence on the presence or absence of stones.

CONCLUSION

Bile duct stones are unlikely after cholecystectomy in patients who are not jaundiced and have a normal-sized common bile duct. However, nearly half of the patients with a wide common bile duct had stones, but the degree of dilatation was not important.