Etiological analysis of bile duct dilatation

Abstract

Objective To investigate the causes of bile duct dilatation. Methods Clinical data of 1 430 patients with bile duct dilatation who were admitted to People's Hospital of Hainan Province between January 2000 and December 2014 were retrospectively analyzed. Among them, 876 were males and 554 were females, aged 13-85 years old with a median age of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. The causes and severity of bile duct dilatation were observed. The relationship between the degree of secondary bile duct dilatation and serum total bilirubin (TB) level was analyzed by Kruskal-Wallis rank-sum test. Results Congenital cystic dilatation of common bile duct accounted for 6.3% (90/1 430). And secondary bile duct dilatation accounted for 93.7% (1 340/1 430), including 28.4% (380/1 340) of mild dilatation, 35.8% (479/1 340) of moderate, 25.4% (341/1 340) of severe and 10.4% (140/1 340) of extremely severe. Common causes of secondary bile duct dilatation were common bile duct stone, pancreatic head carcinoma, periampullary carcinoma, extrahepatic cholangiocarcinoma and chronic pancreatitis, in the order. The degree of secondary bile duct dilatation induced by common bile duct stone, pancreatic head carcinoma, periampullary carcinoma and chronic pancreatitis was correlated with the serum TB level (H=29.401, 9.483, 9.722, 11.907; P<0.05). Conclusions Bile duct dilatation is mainly secondary. The common causes are common bile duct stone, pancreatic head carcinoma, periampullary carcinoma, extrahepatic cholangiocarcinoma and chronic pancreatitis, in the order. The degree of secondary bile duct dilatation induced by common bile duct stone, pancreatic head carcinoma, periampullary carcinoma and chronic pancreatitis is correlated with serum TB level. Key words: Bile ducts; Dilatation, pathologic; Choledocholithiasis; Pancreatic neoplasms; Bile duct neoplasms; Pancreatitis, chronic