Ultrasonographic screening of the common hepatic duct in symptomatic patients after cholecystectomy.

This study was undertaken to assess the usefulness of an ultrasonographically enlarged common hepatic duct as an indicator of biliary obstruction after cholecystectomy. The abdominal sonograms of 165 postcholecystectomy patients were reviewed retrospectively, and follow-up was obtained on 56 patients. In 23 of 36 patients who had common hepatic ducts larger than 4 mm, the cause of biliary obstruction was found at surgery. In the remaining 13 patients, no evidence of obstruction was found on subsequent radiographic studies, and none of these patients underwent surgery. Eight patients had common bile ducts that were considered to be dilated (> 1cm) on subsequent intravenous cholangiography. In 20 patients whose common hepatic ducts measured 4 mm or less, 17 had no evidence of dilatation on subsequent radiographic studies, but three had choledocholithiasis.