Thursday, March 10, 2011

"Common bile duct is dilated"


Common Bile duct is part of the "plumbing" that drains the secretion of the liver (bile) into small bowel (duodenum).  The size of the common bile duct, if dilated, may suggest a blockage downstream. This is a specific finding that is looked for when a patient gets an ultrasound for a suspected liver or Gallbladder disease.
When a patient has their gallbladder removed, the common bile duct dilates over some time. Dilated common bile after a cholecystectomy is of no significance by itself and should only be considered important if there are other findings, such as pancreatitis or elevated liver function tests.

It is, however, important to remember that for any patient who has had the Duodenal switch operation, or the Gastric bypass procedure, the altered anatomy precludes the option of ERCP as a diagnostic or Therapeutic study.


Ara, Keshishian, MD, FACS, FASMBS

12 comments:

  1. I had gallbladder removed in 1982. In 2011, I started throwing up & kept throwing up, went from 127 to 96. Finslky got a good dr, who said I had dilated bile duct & also 14cm cyst on right kidney. Nothing cld be done until cyst was drained. Had that drained in Aug & kept throwimg up. High liver function trsts & low potassium, low calcium(malnurished). Had ERCP in Oct. Got better but still no appetite. Gotta hv cyst removed, since it is growing back. Am scared to eat. Is that normal? Will bilecduct dilate again? What happenrd?

    ReplyDelete
    Replies
    1. Hello,
      I am not sure if I know of any connection between the Gallbladder surgery in 82, and the Kidney cyst. Dilated common bile duct however is common after gallbladder surgery, and this by itself, may result in gallstone formation in the bile duct, (knows as primary biliary stones).
      There are a number of surgical treatment for a primary biliary stone.
      Thank you

      Delete
  2. Hello there. I had my gallbladder removed in September of 2009, when I was 17 years old. No stones, but the doctors said my gallbladder was functioning at 9%. About a week after my surgery, I had very intense pain in my right upper quadrant that went through to my back.. it lasted about 20 minutes. Since then, I've had these random "attacks". Food seems to set them off. The pain is often accompanied with vomiting, and it's so intense it knocks me down and I can't help but scream.. same location as the gallbladder attacks, but a million times worse. I went to the ER last year (2 years after the surgery) for an especially bad attack, and I had a CT scan after the pain had subsided. My organs were all working fine and there were no stones, but there was some biliary duct dilation. I lost my health insurance for a while, but every doctor I've asked has no idea what could be causing the awful pain. I've never had it before the surgery. Could it be related to the bilary duct dilation? Is the dilation a clue?

    ReplyDelete
    Replies
    1. I forgot to mention, during the last ER visit, the doctor verbally mentioned that I had elevated liver enzymes, but said that was common after gallbladder surgery. Is it still common two years after surgery?

      Delete
    2. You may have mild elevation of some of the numbers transiently. Long term elevation of the LFT (liver functions tests) should be evaluated.

      Delete
  3. Hello,
    It appears that your Ejection Fraction (EF) was 9%. The common practice is that patients with no evidence of gallstone, and symptoms of gallbladder (GB) attacks, are evaluated and if the EF is less that 30% then it is removed. This is where the information may get confusing. There is some data that suggests that not in all cases the symptoms resolved after GP is removed. This may be your case. There may be other causes that may mimic your symptoms. May be related to ducts of the GB and the pancreas and anatomical variations.

    Biliary track dilatation is commonly seen after GB removal.Unless you have Gallstones formed in the biliary tree after your GB surgery (this is known and primary biliary stones) then I do not think that your symptoms are results of the dilated ducts.
    Thank you
    Ara

    ReplyDelete
  4. Hi I am a 23 year old female I had my Gullbladder removed a year ago and er doctor told me it was a good idea to see my surgeon again because my bile duct was dilated when it wasn't in previous scans what could this mean I have severe upper quadrant right pain so bad I can't walk at times nor breath and super bad nausea and the pain is worse than before it was removed should I be concerned?

    ReplyDelete
  5. It is common for common bile duct to dilate after the gallbladder removal.

    ReplyDelete
  6. My father is suffering from locally advanced carcinoma Head of pancreas, Underwent SEMS just a month ago.That time CBD was dilated 14.2 mm now its 25 mm. The dilation of CBD again created obstructive jaundice with cholangitis.Is a by pass surgery possible in this case.

    ReplyDelete
  7. Hello,
    Sorry about your fathers condition.
    The dilated common duct and the cholangitis are the result of the obstructive tumor.
    Choledochojejunostomy, or choledocoduodenostomy and even whipple procedure are thoertical option. These all depend on the extend of the disease.
    Ara

    ReplyDelete
  8. Hi there. I have multiple orthopedic problems, afib, and neuromuscular disease, type unknown, and am on tons of medications. Had gallbladder removed 3 yrs ago, due to multiple stones, ongoing pain and nausea. A high-attenuating lesion was seen on liver at that time, but I was not informed of it. I had a mild reaction to tuberculosis test 8 years ago. Pain continued, is often excrutiating and am having nausea again. Often can't make the 189 mile round-trip to ER till days later; liver function tests then show within normal limits. Have lost 60 lbs. New CAT shows lesion has not changed much; doctor hasn't returned my calls. These are govt. drs., and don't have insurance anymore. Can you suggest anything I can ask my doctor to test for or ask about...I am at a loss as what to do, and am so sick now I'm almost helpless. Any ideas could help.

    ReplyDelete
  9. Hello,
    I think there are a lot of issues that are going on which may be causing the elevated liver enzymes.
    Thank you

    ReplyDelete