Bile duct wall thickness measured by intraductal US in patients who have not undergone previous biliary drainage

Background: We investigated the bile duct wall thickness measured on intraductal US in patients who had not undergone biliary drainage, with special attention to the influence of cancer at the distal bile duct, bile duct stones, obstructive jaundice, longitudinal cancer extension, and primary sclerosing cholangitis on wall thickness. Methods: The study included 183 patients. Patients who had undergone previous biliary drainage were excluded. Intraductal US was performed by the transpapillary route with use of a thin-caliber ultrasonic probe (2.0 mm diameter, 20 MHz frequency). The bile duct wall thickness (width of the inside hypoechoic layer) was retrospectively measured on US images. Results: Bile duct wall thicknesses of the common hepatic duct for the control group (n = 95), cancer at the distal bile duct group (n = 9), bile duct stone group (n = 56), and obstructive jaundice group (n = 17) were 0.6 ± 0.3 mm (mean ± SD), 0.8 ± 0.5 mm, 0.8 ± 0.6 mm, and 0.8 ± 0.5 mm, respectively. No significant differences ( p > 0.05) were found between them. However, wall thickness for the cancer extension to the common hepatic duct group (n = 4, 2.0 ± 0.4 mm) and sclerosing cholangitis group (n = 2, 2.5 ± 0.4 mm) were significantly greater than in the other groups ( p < 0.005). Conclusions: In patients who have not undergone previous biliary drainage, the bile duct wall thickness was not thicker in patients with obstructive jaundice. However, the duct wall was significantly thicker in patients with either longitudinal cancer extension or primary sclerosing cholangitis compared with that of other groups. (Gastrointest Endosc 1999;48:199-203)