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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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46 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
    Ara

  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.
    Ara

  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.

      • I went to the hospital over the weekend for one problem and after a ct and an ultrasound, the dr came in and told me I had a dilated bile duct and would need surgery. He didn’t make it sound like a huge deal but after reading through these posts, I am definitely more concerned. I still have my gall bladder. He did say it was full of stones as well. Is this an 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.

  17. hello, 47 year old woman with hep c. no cirrhosis or fibrosis. alt & afp Levels high and ultra sound showed a small lesion on spleen and common bile duct blocked. Dr wants to skip MRI and do ERCP. Im reading that can be risky but he says its the best way to treat/ see whats going on inside and scheduled me for the surgery. Any advise on if I should push MRI first or just get the procedure done? Would prefer to avoid any invasive & risky procedures if not needed. Thanks

  18. Feeling very scared, wondering if you can provide some insight. A few days before XMAS had some terrible discomfort in right upper quadrant (below rib). Mind, this has been ongoing for several years, the discomfort. 2x in the past it resulted in a trip to the ER because the pain was severe. Last trip was about a year ago, everything showed normal and I was sent home. This most recent trip showed a dilated common bile duct 5.8mm, previous had been 4mm. The see no “stone” and have “suspicious for obstruction” on the comments. My question is, I feel this has been an ongoing issue for years. Is this something that can flare up and then go away? I have nausea nearly every day, I have been used to it for years and years. Sometimes it’s worse than others. I have a GI appt this Friday. Feeling very anxious, so scared that I’ve can’t stop crying.

    • Hello Your question raises more questions and I can not answer it intelligently.
      1-do you have a gallbladder?
      2-age
      3-did the pain follow any fatty meals?
      4-any weight gain or weight loss
      5-any jaundice?
      6-and other questions.

      Please see the GI specialists and will require an Ultrasound, possible HIDA scan, possible ERCP or MRCP and other tests in addition to blood work.

      Ara

  19. I have been told that I have a minimal dilated common bile duct. . What does this mean. Do I need my gall bladder taken out.

    • Dilated common Duct may mean a number of things. Is the dilation associated with any pain? jaundice, fever or it was just picked up incidentally? Age is also a factor. All these are best addressed by the treating physician.

  20. I had my gallbladder out about 3 mos ago then still having the attacks and itching I was referred to GI specialist and since my biliary duct was up to 13mm they said I had blockage. I had a tumor that was removed then ended up with pancreatitis the next day even with stint. It has been a month and a half and I still can’t eat most food and having pain and pressure in biliary duct. They did a ultrasound today and duct is only down to 12mm. I don’t have an appt with my surgeon for another week so I’m just wondering if it just takes a long time for swelling to go down or could it still be a problem.

  21. 51 yrs female. Has multiple max size 8mm gallstone and filling defects in cbd. In mrcp cbd dia found 13.7mm. After that in Feb 2017 ercp done and 2 stone 7.4 dia removed. After ercp again mrcp done. It shows dilated cbd 14 mm. GI surgen says that gal bladder and CBD both needs removal.Is Dr. right.

    • Hello, I think you need to clarify this- I do not thing your CBD (common BIle duct) is going to be removed unless there is a tumor or a mass in there. If there is(are) stone(s) and the gallbladder is removed, then a connection is created between the CBD and the duodenum.
      Ara

  22. Hello, I need clarification on this, my friend went for MRI and it was found out that her gall bladder is enlarged…is there a remedy for this and what should be done for her

  23. Hello, I am female 49 years old, and back in january 1999, I had my gallbladder out. I have had CT scans over the course of time since then, not many, but there was never any dialation on the CBD even my CT scan from June 2016 it was fine. For this last year, I been declining, not eating weight loss, low grade fevers they run from 99.2-101 I am severely fatigued whole body fatigued actually, and I am continuing to go down hill right now my weight loss is 2+ pounds a week (that is a conservative number), I have been going thru tests and they repeated my CT scan end of March 2017 and now I all of a sudden have a 7mm dialated CBD, my wbc and alt and ast and such are normal- I do have some tests that are off, but are urine related, I currently have and had trace blood in my urine the past year, my creatinine is a touch high but not much, it is 1.3 (range is (0.5 – 1.2) , urine squamous epithelial cells 3+/lpf and my estimated GFR non african american is low 44 ( range >60) urine bacteria 1+ and urine mucous 1+ and Potassium is a tad low 3.2 (range 3.4-5.4) Ohhh I have stage 3 kidney disease, sjogrens syndrome, swollen lymphnodes in my neck and my right armpit feels like there is something in there when my arm is at rest, I had a rare septecemia May 2016 with no cause, was deep in the muscle that ran from the sternum to the left AC joint, no sores no cause,( kidney disease came from this as the septecemia ) that is why I had a ct again back in June 2016 and my CBD was normal at that time as I mentioned. My symptoms, extreme nausea no meds help, vomitting, weight loss, whole body fatigue, whole body aches, low grade fevers, ohh and last spring 2016 for the first time a 3mm angular nodule in the upper right lobe of the lung was found, and the recent CT march 2017 showed same nodule same 3mm but a new change is Linear fibroatelectatic change is present
    within the inferior lingula. so because they say my blood work is normal, besides what I listed, they dont’ know what is wrong, any ideas? I know the CBD can dialate over time, but in 18 years, there was no change to the CBD after my gall bladder was removed back in Jan 1999, until March 2017, and not even last March 2016 it was normal and now 7mm out of the blue…I am confused, should I be going for a second opinion or do I have nothing to worry about as, the Doctor said if it was serious, my blood work would be bad, such as ast and alt and whatever else . Any suggestions at all, or is this just going to be this way. with my symptoms I am confused, and these symptoms over the last year have been getting worse and worse and worse (a gradual decline) and the last couple months the decline is going a little faster now. I understand my dr says there is no cancer, due to my blood work being okay, but there is something wrong, becaue this is not normal for me this past year.

      • Do you have any suggestions, that I could possibly bring up to my doctor, that maybe they are not thinking of, or at least I can discuss with him?? With your expertise, I would appreciate that.

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