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Are dilating bile ducts a cause for concern?
  1. M L WILKINSON
  1. Gastroenterology Laboratory
  2. GKT 4th Floor, North Wing
  3. St Thomas’s Hospital
  4. London SE1 7EH, UK

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See article on page 741

Whether the bile duct dilates after cholecystectomy is a hoary old chestnut dating back to Oddi and hotly debated in the era of intravenous cholangiography but is still of practical importance now. In this issue Majeed et al (see page 741) report a careful, but uncontrolled study from Sheffield examining this question. Fifty nine patients undergoing cholecystectomy had their common hepatic duct diameters measured ultrasonographically before and three, six, 12, and 60 months after surgery. Those with ducts of >5 mm preoperatively were excluded. A slight mean increase was found and more importantly, perhaps, about 5% of subjects at six months and one year had ducts greater than the arbitrary cut off limit of 6 mm. At five years only one of the 48 at risk seemed to maintain the increase in size. One wonders whether the radiologist’s technique and interpretation at five years were identical to those at the outset. Furthermore, by the end of the study the ultrasound machine was at least nine …

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