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What is the significance of dilation of the common bile duct?
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What is the significance of dilation of the common bile duct?

I've looked all over the internet trying to find the answer to this question.  Then I remembered all of the experts here!  My ultrasound in December said "The common bile duct is again noted to be mildly dilated up to 7.8mm in diameter ... then MRCP or ERCP could be performed."  So "again" must mean that finding has been on a previous ultrasound that I missed when reading it.  Translations would be welcome!  :)
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19 Comments Post a Comment
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148588_tn?1411507419
All the experts must be asleep. Plugging 'mrcp ercp' into my search engine  got about 30,000 results. MRCP appears to be a magnetic resonance method of diagnosing problems of the pancreas and bile system and ERCP an endoscopic method of doing the same.

http://www.ncbi.nlm.nih.gov/pubmed/12079266
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163305_tn?1333672171
Okay, I'm no expert but I did have an ERCP for bile duct issues.
It was a simple outpatient procedure. I was knocked out for about 20minutes and someone had to drive me home.
The only side effect is a slight sore throat.

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179856_tn?1333550962
I was going to post earlier and just say Chris, Friday night is the worst time to ask a real serious question... The smarties will be around but mostly, you have us .. Clowns.

They  will post but DS and OH some of the smarties...hang in there.
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446474_tn?1404424777
What does your hepatologist or gastroenterologist say about you having a dilated common bile duct?

Are they trying to diagnose the cause>

You are experiencing symptoms of biliary disease?
Jaundice, biliary pain or fever? Did they find a biliary lesion?

A dilated (> 7 mm) biliary tree can sometimes indicate a biliary obstruction. IE lesion.

(MRCP) magnetic resonance cholangiopancreatography is usually used to help diagnosis the biliary issue.

ERCP (endoscopic retrograde cholangiopancreatography is a technique that combines the use of endoscopy and fluoroscopy to diagnose and more often treat certain problems of the biliary or pancreatic ductal systems. Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the ducts in the biliary tree and pancreas so they can be seen on X-rays.

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"Dilated bile ducts

Bile ducts from the liver and the gallbladder join together to form the common bile duct. This duct drains into the small bowel and delivers bile to this portion of the small bowel known as the duodenum. Bile helps in the breakdown of undigested food and also gives color to bowel motions. Whenever a blockage occurs in the bile duct, the bile ducts become enlarged or dilated. An individual may first notice a pale color to the bowel motions and a darkening of the urine, if the blockage or obstruction progresses, a yellow discoloration to the eyes and skin (jaundice) may occur.
Obstruction of the bile duct can occur for several reasons and always warrants further investigation. Common causes include gallstones that become dislodged from the gallbladder and travel down the bile duct to the point at which it drains into the duodenum. This is the narrowest part of the bile duct and gallstones can become blocked or impacted at this point. This area is also the site at which the pancreas drains into the duodenum. A blockage caused by a gallstone is usually painful, may occur with fevers and can also be associated with inflammation of
the pancreas (pancreatitis). Less commonly, obstruction of the bile ducts maybe secondary to a tumor of the bile duct, known as a cholangiocarcinoma, or a tumor of the head of pancreas. This type of bile duct obstruction is usually painless but maybe associated with weight loss.
The majority of individuals with dilated bile ducts require an ERCP (endoscopic retrograde cholangio-pancreatiogram). This test maybe done as a day case, is carried out under heavy sedation, and involves the injection of dye from the small bowel into the bile duct. During this test, stones can be removed from the bile duct, tumors can be biopsied and the obstruction can be relieved. Alternatively, an MRCP (MRI scan of the bile ducts) can further determine the cause of dilated bile ducts but is of diagnostic value only.
A slightly dilated common bile duct maybe seen in individuals who have had a cholecystectomy in the past and does not warrant further investigation. All other cases of dilated bile ducts require referral to a gastroenterologist who specializes in the technique of ERCP."
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Best of luck!
Hector  
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Avatar_m_tn
I had the diagnosis of dilated common duct about 8 yrs. ago.  My PCP didn't follow up on it.  Said that it's usually an indication of stones but that my ultrasound didn't show any.  However, the following year the annual ultrasound showed a huge HCC that had metastasized to the inferior vena cava.  I have to wonder if the dilated duct was connected in some way.
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446474_tn?1404424777
Your PCP didn't follow up because they thought it was stones. Well it could be stones or any other thing that can cause blockage of the biliary tree. I don't know for sure and even a good MRI doesn't always show everything that is there. So who knows if some HCC was blocking the biliary tree.

Metastasized to the inferior vena cava? OMG That must have been a nightmare. I am so sorry.
It makes horrible sense that it would metastasize to the vena cave as that is the route the blood flow of the liver cycles back into your heart.
You must have been at a very good transplant center for them to be able remove all of the cancer from your vena cava and keep it functional. They probably took out a whole section and then used the donor liver's vena cava. Luckily it must have been a close fit. Wow those surgeons are brilliant! Glad you got excellent treatment. At many centers that would have been a death sentence. Scary.
Did they get all the cancer out of your vena cava when you had your transplant? Wow you are so lucky. You are a miracle. I have heard some terrible stories but that is really horrible.

I am so glad that you got a transplant and they got all of the cancer. Gee I've only had two 2cm tumors. One in my left lobe and now I have one in my right lobe. I will be having another TACE treatment on the 22nd to give it a good dose of chemo. Doxorubicin eluting beads (DEB). I have about a year to transplant as I only have a MELD of 22 right now. So I have to manage the cancer until I can get a transplant. Very stressful and scary. Happy you made it to the other side!

Take care!
Hector
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Avatar_m_tn
You are so helpful!  Seriously.  I researched different web sites and found out what the two ERCP or whatever are.  What I wanted to know was how it was relevant to HepC or what its implication was.  I'll think good thoughts for you, Hector.  You sound right where I don't want to be.
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Avatar_m_tn
And thank you for putting a different spin on what was said before about the smart-a** comments.  Sometimes I can laugh and sometimes I can't.  You seen to understand that.  :)  Weekends probably aren't the best time to post what I did.  Shows you how much of a life I have, but at least so far I have one.
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1494170_tn?1361754460
Hey Chris, I'm jus one of da clowns but I try and offer any support I can when I can and shows you how much of a life I have too but like you said at least we have one and I am VERY grateful to be able to attempt to rid myself of this HCV on the triple dose. Hope they get things under control for you.

My hat is off to you Hector, Transplantgal, and OH

Wishing you all the Very Best
Gene
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1856494_tn?1340546214
For me, you are the warriors I chose to fight this war with because you are so brave.  Hard to feel sorry for ones self with these compassionate heroes around showing us the way.    
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Avatar_f_tn
I had dilated common bile duct and liver enlargement but dr  gastrologist said since I have no pain in right side then will be no problem.  I do have pain in left stomach side (from middle to left side of stomach).
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338734_tn?1377163768
ERCP (endoscopic remote procedure) is just a method of getting a scope/tools into the duodenum and bile duct. From there they can do close up imaging as needed or use the tools to place stents or do other tasks.

I had a couple of them after transplant to place and remove a stent from my bile duct where the graft was located.
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338734_tn?1377163768
Paint my nose red and stuff me in a little car! :-)
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6692862_tn?1383813711
In regards to the discussion of the dilated common bile duct, I recently went through an Ultrasound and an MRI with imaging dye and no cancer was found. However, I was not given a cause or a cure for the dilation and will have to have follow-up via blood draws every 3 months and another MRI in a year. If I would have lived in a legal state the Specialist said that he would have prescribed Medical Marijuana. I'm leery of taking pain medication because of the side effects and I have pain on the right side of my abdomen which radiates to my the right side of my back and the left side of the abdomen. It is not constant and seems to be activated by exercise, stress and either too much or too little food. The pain is nothing like the knife-like agony I presented at the ER with. I wonder if it's possible for this to get better on it's own? There are also elimination issues and nausea. Anyway, I have grown tired of thinking and acting like a sick person waiting to die. By the grace of God, my attitude has changed and I have gotten back to the gym for moderate workouts, have considered going back to work part-time and am now considering  taking Martial Arts classes at 40, something I have always wanted to do which I hope will build my confidence and help me beat the symptoms of this illness by staying in a positive and self-empowered head space. Any comments or feedback would be appreciated:-)
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Avatar_f_tn
Hi, how much is your common duct dilatated?  I just had ultrasound showing 8mm dilatation, had MRCP showing normal liver, gallbladder and pancreas; blood work was unremarkable.  I an scheduled for an ERCP next week, am surprised your doctor did not insist on that procedure as there has to be an underlying cause for the dilatation.  Are you having any symptoms?
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1840891_tn?1383280315
I had an enlarged bile duct for years that was treated as "no big deal" and considered just the normal enlargement for someone who'd had their gall bladder removed. Then at one point I had some symptoms of sudden emptying after eating a fatty meal and my hepatologist insisted on an ercp, including the duct into the pancreas. I was still not given a very specific dx for a couple of years until a new hepatologist and liver transplant surgeon joined Stanford's staff after years of practicing in Japan. The new team reviewed my existing records and made a dx of a congenital choledochal cyst. It's extremely rare in the west but much more common in the east. It carries a 25% risk of a highly fatal form of cancer. I had to undergo a very difficult surgery to remove all the ducts (unfortunately adjacent to the major blood flow lines), the remove part of my small intestine in order to utilize the tissue to construct brand new ducts for me, and have a roux-en-Y to reconnect my intestines! Not a liver transplant, but an 8 hour surgery by the transplant team.  It IS extremely rare in the west, so its not a likely problem in your case but it does make me want to encourage everyone to look into those bile duct enlargements and not discount them too quickly.
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Avatar_m_tn
when going mrcp common bile duct shows mild fusiform dilation in the proximal part (approx.13mm) and shows gradual distal tapering. and the gallbladder with  multiple intraluminal signal voids suggestive of calculi are seen .the liver is mildly enlarged with span of 16cm .a  2cm diameter fluid signal intensity suggestive of simple hepatic cyst .can we say the dilation as type 1 choledochal cyst
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Avatar_m_tn
I have the same problem as yours just back from the specialist and so far the MRI with dye showed same dilation size as before but had an episode of maybe pancreatitis or CBD infection that i was admitted to the hospital for 4 days, severe abdominal pain, increased WBC, pancreatic and liver enzymes. I still cant decide if the roux n y surgery is the best option i will seeing a naturopath soon.
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1840891_tn?1383280315
Were you hospitalized in a place with a good liver transplant team? You should be seen by specialists of this caliber and should be getting to hear their advice and opinions. I don't think you can make a truly informed decision without the best information. Your history definitely warrants the full investigation by this kind of team. Then you can decide what you are willing to risk and whether to go the surgical route or hope for the best. A naturopath is in no way competent to evaluate all the possible ramifications of this problem. I don't mean to trash naturopaths - few specialists are fully competent for something like this and certainly not any of the generalists out there.  You really need the advice of someone who has extensive close experience with these problems.
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