Post Roux-en-Y Gastric Bypass Biliary Dilation: Natural Process or Significant Entity?

Abstract

Hepatic duct diameter increases after Roux-en-Y gastric bypass. A better understanding of this phenomenon may limit the need for further work-up in patients with incidentally detected biliary dilation.

Ampullary stenosis and choledocholithiasis post Roux-En-Y gastric bypass: challenges of biliary access and intervention

“…The pathophysiology of benign ampullary stenosis after RYGB remains speculative, with theories centering on disruption of stomach-duodenal continuity causing changes in neuromyenteric regulation of the sphincter of Oddi, or intraoperative vagal nerve injury leading to denervation of the sphincter of Oddi. 6,9,[21][22][23] To our knowledge, ampullary stenosis has not been described in patients who underwent sleeve gastrectomy for weight loss, which lends support to those theories. Additional mechanistic studies are needed, but the findings from our series suggest a potential contribution from patient comorbidities (i.e.…”

Gallstones: Watch and wait, or intervene?

“…31 The normal bile duct diameter ranges from 3 to 6 mm, although mild dilation is often seen in older patients or after cholecystectomy or Rouxen-Y gastric bypass surgery. 32,33 Bile duct dilation of up to 10 mm can be considered normal in patients after cholecystectomy. 34 A normalappearing bile duct on ultrasonography has a negative predictive value of 95% for excluding common bile duct stones.…”