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“Common bile duct is dilated”

Posted On : March 10, 2011  
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
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30 responses to ““Common bile duct is dilated””

  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?

  2. 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

  3. 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?

  4. 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

  5. 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?

  6. 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?

  7. 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.

  8. 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.

  9. 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.

  10. Does it continue to dilate further over years? Recent studies show increased dilation by quite a few mm as I have been continuing to have gallbladder attack like symptoms every day. Mine was remove in 1990. Has gone from 10 mm to 13 mm in the last year and a half according to this weeks sonogram…presently awaiting mri results to look further.

  11. Had CT for lung mass, then bronchoscopy – all OK – NO Ca.
    Coincidentally CT picked up dilated CBD. I think I was copied into a letter possibly in error which is how I found out. I do have FU appt – what is likely to be done by way of investigations – have never had Gall Bladder surgery – only symptom is quite severe upper right abdo discomfort plus generalised abdo discomfort and weight loss.

  12. I had my gallbladder removed in 2004. The pain prior to the removal of the gallbladder was excruciating To the point of complete delirium I was told by The surgical team that there Were numerous gallstones and apparently they were not all removed at the time of the gallbladder surgery, henceforth I developed gangrene. I was sent to San Francisco to a specialist who performed an ERCP and after two weeks in the hospital and several months of recovery I am still having issues! I was told it was only scar tissue , but an ER doctor recently told me My common bile duct is dilated , Could it be possible that one of those gallstones could still be lodged in the common bile duct after this many years?

    • Hello- If the stone in the common duct is seen before 2 years then it is considered a retained stone from the time of the gallbladder surgery. IF the stone in the duct is seen after two years of the gallbladder surgery then it is knows and “Primary Biliary Stone” (PBS).
      PBS needs treatment, ERCP or surgical at times.

  13. Hello. Had an MRI four days ago, findings are “common bilary duct dialation” I had my gallbladder removed over a year ago. I also have crohns disease. They are ordering an ERCP and marked a referral “urgent” to the Medical University in my state. I have had pain when I eat for Seven- months. I asked for an MRI i am always told it’s a “crohns flare” when I go to the doc or ER. My blood work isn’t great as far as markers for pancreatitis and “liver function” which I know could mean an abundance of things… they say it may be a “complication” from a previous surgery. My question is, why are they sending me to a surgeon?

    • Hello- I can not answer why you re being sent to a surgeon. The reasons for evaluating this further is the association of Primary Sclerosing Cholangitis” with patient who have inflammatory bowel disease. This association is much more common with the Ulcerative colitis that the Chron’s disease.

  14. Hi I 37 years old and have IBS and have a small gallstone. The doctor told me that I have a dilated common bile duct and need to see a gastro. Is that bad?

    • I think you should see a surgeon- and not necessarily a Gastroenterologist.A gallstone in the common duct, can become a surgical emergency.

    • The common duct is the tubular structure that delivers the bile from the liver-gallbladder to the small bowel. When the gallbladder is removed, the common bile duct dilates. If a patient has a dilated common duct and still has their gallbladder then this is much more source for concern.

  15. Hello,
    I am 34 years old and have had terrible upper abdominal/shoulder pain, nausea and vomiting off and on for 2 years. I had an ultrasound 2 years ago that showed a 12mm common bile duct, everything else was normal. All of my blood work is normal. Was told I had sphincter of oddi dysfunction. This summer the pain came back with a vengeance. My common bile duct was 17mm, distended gallbladder with wall thickening, no stones/sludge, normal blood (except elevated WBC). Diagnosis of Choledochal Cyst, but no-one knows what that is or what to do with it so sent me to have my gallbladder removed, surgeon again said I had a choledochal cyst. Sent me to Washington University, did an MRCP, normal blood again and agreed I “probably” have a small type 1C choledochal cyst. They want to do another MRCP in 6 months. I still have terrible pain & nausea. I was under the impression choledochal cysts should be removed. Could 17mm common bile duct be something other than a choledochal cyst? Thanks!!!

    • Hello,
      You said “.distended gallbladder with wall thickening, no stones/sludge, normal blood (except elevated WBC)”
      You have cholecystitis and your gallbladder needs to come out. Other compounding variables are: diabetes, obesity, pregnancy, smoking.
      The rest of the information is sort of irrelevant until your gallbladder is out.

      • Thank you for your reply! I had my gallbladder out 2 months ago but am still having symptoms. MRCP showed my common bile duct as 17mm last week. It’s suspected I have a small choledochal cyst, but because it’s so small they want to do another MRCP in 6 months rather than surgery. Could my gallbladder have dilated my common bile duct? When does a bile duct go from dilated to choledochal cyst? Thanks again.

  16. I am not sure gallbladder dilates common duct. Gallbladder removal over time will result in dilation of the common duct.

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