Karamanos Efstathios, Inaba Kenji, Berg Regan J, Resnick Shelby, Okoye Obi, Alexopoulos Sophoclis, Chouliaras Konstantinos, Demetriades Demetrios
Division of Trauma, Acute Care Surgery and Surgical Critical Care, Department of Surgery, LAC + USC Medical Center, University of Southern California, Los Angeles, CA, USA.
Dig Surg. 2017;34(5):421-428. doi: 10.1159/000455272. Epub 2017 Jul 1.
Aging has been associated with increasing common bile duct (CBD) diameter and reported as independently predictive of the likelihood of choledocolithiasis. These associations are controversial with uncertain diagnostic utility in patients presenting with symptomatic disease. The current study examined the relationship between age, CBD size, and the diagnostic probability of choledocolithiasis.
Symptomatic patients undergoing evaluation for suspected choledocolithiasis from January 2008 to February 2011 were reviewed. In the cohort without choledocolithiasis, the relationship between aging and CBD size was examined as a continuous variable and by comparing mean CBD size across stratified age groups. Multivariate analysis examined the relationship between increasing age and diagnostic probability of choledocolithiasis in all patients.
Choledocolithasis was diagnosed by MR cholangiopancreatography (MRCP) or endoscopic retrograde (ERCP) in 496 of 1,000 patients reviewed. Mean CBD was 6.0 mm (±2.8 mm) in the 504 of 1,000 patients without choledocolithiasis on ERCP/MRCP. Increasing age had no correlation with CBD size as a continuous variable (r2 = 0.011, p = 0.811). No difference occurred across age groups (Kruskal-Wallis, p = 0.157). Age had no association with diagnostic likelihood of choledocolithiasis (AOR [95% CI] 0.99 [0.98-1.01], adjusted-p = 0.335).
In a large population undergoing investigation for biliary disease, increasing age was neither associated with increasing CBD diameter nor predictive of the likelihood of choledocolithiasis.
衰老与胆总管（CBD）直径增加有关，并且据报道可独立预测胆总管结石的发生可能性。这些关联存在争议，对于有症状疾病的患者，其诊断效用尚不确定。本研究探讨了年龄、CBD大小与胆总管结石诊断概率之间的关系。
回顾了2008年1月至2011年2月因疑似胆总管结石接受评估的有症状患者。在无胆总管结石的队列中，将衰老与CBD大小的关系作为连续变量进行研究，并通过比较不同年龄分层组的平均CBD大小来分析。多变量分析研究了所有患者年龄增加与胆总管结石诊断概率之间的关系。
在1000例接受评估的患者中，496例通过磁共振胰胆管造影（MRCP）或内镜逆行胰胆管造影（ERCP）诊断为胆总管结石。在ERCP/MRCP检查中无胆总管结石的1000例患者中的504例，其平均CBD为6.0毫米（±2.8毫米）。年龄增加与作为连续变量的CBD大小无相关性（r2 = 0.011，p = 0.811）。各年龄组之间无差异（Kruskal-Wallis检验，p = 0.157）。年龄与胆总管结石的诊断可能性无关（优势比[95%可信区间]0.99[0.98 - 1.01]，校正p = 0.335）。
在一大群接受胆道疾病检查的人群中，年龄增加既与CBD直径增加无关，也不能预测胆总管结石的发生可能性。
