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Biliary Duct Dilatation: AJR Expert Panel Narrative Review.

Biliary Duct Dilatation: AJR Expert Panel Narrative Review.

Authors :
Ludwig DR
Itani M
Childs DD
Revzin MV
Das KK
Anderson MA
Arif-Tiwari H
Lockhart ME
Fulcher AS
Source :
AJR. American journal of roentgenology [AJR Am J Roentgenol] 2024 Apr; Vol. 222 (4), pp. e2329671. Date of Electronic Publication: 2023 Jul 26.
Publication Year :
2024

Abstract

Biliary duct dilatation is a common incidental finding in practice, but it is unlikely to indicate biliary obstruction in the absence of clinical symptoms or elevated levels on liver function tests (LFTs). However, the clinical presentation may be nonspecific, and LFTs may either be unavailable or difficult to interpret. The goal of this AJR Expert Panel Narrative Review is to highlight a series of topics fundamental to the management of biliary duct dilatation, providing consensus recommendations in a question-and-answer format. We start by covering a basic approach to interpreting LFT results, the strengths and weaknesses of the biliary imaging modalities, and how and where to measure the extrahepatic bile duct. Next, we define the criteria for biliary duct dilatation, including patients with prior cholecystectomy and advanced age, and discuss when and whether biliary duct dilatation can be attributed to papillary stenosis or sphincter of Oddi dysfunction. Subsequently, we discuss two conditions in which the duct is pathologically dilated but not obstructed: congenital cystic dilatation (i.e., choledochal cyst) and intraductal papillary neoplasm of the bile duct. Finally, we provide guidance regarding when to recommend obtaining additional imaging or testing, such as endoscopic ultrasound or ERCP, and include a discussion of future directions in biliary imaging.

Details

Language :
English
ISSN :
1546-3141
Volume :
222
Issue :
4
Database :
MEDLINE
Journal :
AJR. American journal of roentgenology
Publication Type :
Academic Journal
Accession number :
37493325
Full Text :
https://doi.org/10.2214/AJR.23.29671