Effect of aging on common bile duct diameter: A real‐time ultrasonographic study

Abstract

Using a high-resolution real-time scanner, a technique has been established in our laboratory for visualizing the entire extrahepatic bile duct with multiple longitudinal oblique approaches and, if necessary, several transverse scans through the pancreatic head. To determine the normal size of the extrahepatic bile duct and to evaluate the effect of aging on the duct diameter, 256 healthy subjects and patients without hepatobiliary disease were examined using this technique from January to August, 1982. The entire extrahepatic duct was detected in 203. The inner diameter of the widest point of the duct varied from 1 mm to 10 mm, and was found to be age-dependent (r = 0.60, P less than 0.001). It is concluded that, based on the visualization of the entire extrahepatic duct echographically, the normal inner diameter of common bile duct can be up to 10 mm, and there is a mild change of duct size with age.

¿Cuál es el tamaño normal del conducto biliar común?

“…La disponibilidad de exámenes diagnós-ticos que permitan una adecuada evaluación y medición del CBC y la correlación con los parámetros de normalidad permite distinguir la presencia de colestasis secundaria a obstrucción frente a la colestasis no obstructiva (1, 3), aunque existe una plétora de literatura publicada en relación con el tamaño normal del CBC, con gran heterogeneidad en cuanto al diseño, la técnica de medición (dentro de los cuales los más utilizados actualmente incluyen: la ecografía transabdominal [ (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16), los cuales han permitido fijar el límite superior normal, convencionalmente en 6 mm, aunque es algo arbitrario y dependiente de diferentes factores (edad, antecedentes quirúrgicos, técnica de medición, sexo, peso, realización de la medida posprandial, consumo de medicamentos, entre otros) (17)(18)(19).…”

Common bile duct measurements in an elderly population.

“…articles have been published describing the changes in caliber of the CBD related to various factors, including hepatobiliary disease, cholelithiasis, 1-3 patient's age, [4][5][6] and associated renal disease 7 or liver transplantation. 8 Extrinsic factors, such as time of day, 9 respiration, 10 or patient positioning during the examination, 11 also have been shown to affect the caliber of the CBD.…”

Endoscopic ultrasound in common bile duct dilatation with normal liver enzymes

“…Finally, magnification and duct distension by contrast, used in ERCP and transhepatic cholangiography, may overestimate duct size [8] . Several studies in the last 20 years reported an increase in the CBD diameter in older patients, even if with consistent variability [6,7,9,10,12] . Based on autoptic observations, some authors identified loss of elastic fibers and proximal compensatory dilatation due to distal sclerosis as potential causes of the phenomenon [13] .…”

“…A variety of factors can influence bile duct size, prominently imag ing modality, age [7][8][9][10] and prior cholecystectomy. In transabdominal ultrasound (TUS), distal CBD may be difficult to visualize because of bowel gas, thus resulting in underestimation of duct size compared to other imaging techniques as computed tomography (CT), magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) [11] .…”