Abstract
We sought to measure cystic duct diameter in patients without biliary calculi and in those with cholelithiasis or choledocholithiasis. Using endoscopic retrograde cholangiopancreatography (ERCP), we visualized the cystic duct in 168 patients referred to our unit. These patients were distributed into three groups based on findings at ERCP: Group I (N=57), no calculi in the gallbladder or common bile duct; group II (N=27), stones found in the gallbladder but absent from the common bile duct; and group III (N=34), stones present in the common bile duct with or without gallbladder stones. The diameter of the cystic duct was measured at its widest and narrowest dimensions. The largest diameter measured was greater in group III (7.72±2.29 mm) than in groups I (2.63±0.67 mm) and II (4.59±1.13 mm) (P<0.001). The same differences were found in measurement of the smallest diameter (5.00±0.99 mm, 3.10±0.62 mm, and 1.83±0.53 mm, for groups III, II, and I, respectively) (P<0.001). Maximal and minimal cystic duct diameter show a progressive increase at each level of disease. This increase in cystic duct size may facilitate the migration of gallstone fragments after lithotripsy and facilitate the instrumentation of the cystic duct during ERCP and laparoscopic cholecystectomy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Acosta JM, Ledesma CL: Gallstone migration as a cause of acute pancreatitis. N Engl J Med 290:484–487, 1974
Kelly TR: Gallstone pancreatitis: Pathophysiology. Surgery 80:488–492, 1976
Houssin D, Castaing D, Lemoire J, Bismuth H: Microlithiasis of the gallbladder. Surg Gynecol Obstet 157:20–24, 1983
Sackmann M, Delius M, Sauerbruch T et al: Shock-wave lithotripsy of gallbladder stones. The first 175 patients. N Engl J Med 318:393–397, 1988
Delmont JP, Magnier M, Hosnier H, Moreaux J, Guivarc'h M, Sokolowsky S, Capdeville R, Branche D: Résults of the gallstone lithotripsy in 212 patients using the EDAP LT 01.In Biliary Lithotripsy. JT Ferrucci, M Delius, HJ Burhenne (eds). Chicago, Year Book Medical Publishers, 1989, pp 95–102
Pelletier G, Delmont J, Capdeville R, Hosnier H, Raymond JM, Collet D, Caroli FX, Moreaux J, Guivarc'h M, Amouretti, M: Treatment of gallstones with piezoelectric lithotripsy and oral bile acids. A multicenter study. J Hepatol 12:327–331, 1991
Barkun ANG, Ponchon T: Extracorporeal biliary lithotripsy. Review of experimental studies and a clinical update. Ann Intern Med 112:126–137, 1990
Greiner L, Munks C, Heil W, Jakobeit C: Gallbladder stone fragments in feces after biliary extracorporeal shock-wave lithotripsy. Gastroenterology 98:1620–1624, 1990
Schoenfield LJ, Berci G, Carnovale RL, Casarella W, Caslowitz P, Chumley D, Davis RC, Gillenwater JY, Johnson AC, Jones RS: The effect of ursodiol on the efficacy and safety of extracorporeal shock-wave lithotripsy of gallstones. N Engl J Med 323:1239–1245, 1990
Maher JW, Summers RW, Dean TR, Swift J, Heitshusen D, Quinn G: Early results of combined electrohydraulic shockwave lithotripsy and oral litholytic therapy of gallbladder stones at the University of Iowa. Surgery 108:648–654, 1990
Foerster EC, Matek W, Domske W: Endoscopic retrograde cannulation of the gallbladder: Direct dissolution of gallstones. Gastrointest Endosc 36:444–450, 1990
Berci G: Laparoscopic cholangiography.In Laparoscopic Biliary Surgery, 2nd ed. A Cuschieri, G Berci (eds). Oxford, Blackwell Scientific, 1992, pp 116–131
Barbara L, Sama C, Morselli-Labate AM, Taroni F, Rusticali AG, Festi C, Roda E, Banterle C, Puci A: A population study on the prevalence of gallstone disease: The Sirmione study. Hepatology 7:913–917, 1987
McMahon MJ, Shefta JR: Physical characteristics of gallstones and the calibre of the cystic duct in patients with acute pancreatitis. Br J Surg 67:6–9, 1980
Acosta JM: The role of the sphincter of Oddi in acute pancreatitis. Gastroenterol Clin Biol 12:533–536, 1988
Taylor TV, Armstrong CP: Migration of gallstones. Br Med J 294:1320–1322, 1987
Delmont J, Dumas R, Grimaldi C: Fonctionnement physiologique et dysfonctionnements du sphincter d'Oddi (sténose oddienne bénigne et dyskinésie). Gastroenterol Clin Biol 12:453–458, 1988
Jensen KH, Jorgensen T: Incidence of gall stones in a Danish population. Gastroenterology 100:790–794, 1991
Hutton SW, Sievert CE Jr, Vennes JA, Shafer RB, Duane WC: Spontaneous passage of glass beads from the canine gallbladder: facilitation by sphincterotomy. Gastroenterology 94:1031–1035, 1988
Delius M, Enders G, Brendel W: Passage of stone fragments from the gallbladders of dogs. Surg Gynecol Obstet 166:242–244, 1988
Catnach SM, Fairclough PD, Trembath RC, O'Donnell LJ, McLean AM, Law PA, Wickham JE: Effect of oral erythromycin on gallbladder motility in normal subjects and subjects with gallstones. Gastroenterology 102:2071–2076, 1992
O'Donnell LJ, Wilson P, Guest P, Catnach SM, McLean A, Wickham JE, Fairclough PD: Indomethacin and postprandial gallbladder emptying. Lancet 339:269–271, 1992
Feretis CB, Malas EG, Mansouras AJ, Koutsoumanis CG, Apostolidis NS, Papadimitriou JD, Golematis BC: Endoscopic transpapillary catheterization of the gallbladder followed by external shockwave lithotripsy and solvent infusion for the treatment of gallstone disease. Gastrointest Endosc 19–22, 1992
Ponchon T, Baroud J, Mestas JL, Chayvialle JA: Gallbladder lithotripsy: Retrograde dissolution of fragments. Gastrointest Endosc 34:468–469, 1988
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Castelain, M., Grimaldi, C., Harris, A.G. et al. Relationship between cystic duct diameter and the presence of cholelithiasis. Digest Dis Sci 38, 2220–2224 (1993). https://doi.org/10.1007/BF01299899
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01299899