What happens if the bile duct is dilated after cholecystectomy?

If cholecystitis or gallstones are severe, cholecystectomy may be required. After a period of treatment, bile duct dilatation may occur. The more common cause is congenital bile duct malformation. At this time, good treatment is also needed. Some antibiotics can be used for treatment. In daily life, we should also emphasize nutrition, especially pay attention to dietary conditioning.

Common types of bile duct dilatation are common congenital bile duct malformations. In the past, it was considered to be a lesion limited to the common bile duct, so it was called congenital common bile duct cyst. Caroli first described cases of multiple cystic dilatations of the intrahepatic terminal bile duct in 1958. Therefore, congenital intrahepatic bile duct dilatation is also called Caroli disease. It belongs to congenital cystic fibrosis of the liver and is believed to be autosomal recessive. It is more common in males and is mainly seen in children and young people. Cases reported in the early years were not accompanied by liver fibrosis and portal hypertension, but in later reports, 2/3 of the cases were accompanied by congenital liver fibrosis, and were often accompanied by various renal lesions, such as polycystic kidney disease, etc. Late cases were complicated by cirrhosis and portal hypertension. According to Sherlock's classification, it is divided into four categories: congenital hepatic fibrosis, congenital intrahepatic bile duct dilatation, congenital common bile duct dilatation and congenital liver cysts, collectively known as hepatic and biliary fibrosis polycystic disease.

One or more lesions may exist in the hepatobiliary system at the same time. The pathological and clinical characteristics of this disease are bile duct inflammation and stones caused by intrahepatic bile duct dilatation and cholestasis. However, since the clinical symptoms are often atypical, it can occur at any age with recurrent attacks of right upper abdominal pain, fever and jaundice. The liver is noticeably enlarged during an attack, but once the infection is controlled and symptoms improve, the liver will often shrink rapidly. Liver function impairment is not proportional to clinical symptoms. In the early stage of the disease, it is often diagnosed as cholecystitis or liver abscess. If it is combined with other fibrocystic lesions such as congenital liver fibrosis or extrahepatic bile duct dilatation, the symptoms will be more complicated, and symptoms of cirrhosis, extrahepatic bile duct obstruction, and urinary tract infection may appear. Often the diagnosis cannot be made and surgical intervention is often necessary to confirm the diagnosis. In recent years, due to the application of diagnostic methods such as ultrasound imaging and various cholangiography techniques, the correct diagnosis of intrahepatic lesions can be obtained, so case reports have increased day by day. However, secondary bile duct dilatation caused by compression for other reasons is often included, which has caused confusion in the concept of Caroli's disease.

The main treatment method is to prevent and treat cholangitis, with long-term use of broad-spectrum antibiotics, but the treatment effect is generally unsatisfactory. Due to the extensive nature of the lesions, surgical treatment is often unsuccessful. If the lesions are limited to one lobe, liver lobectomy may be performed, but it is reported that less than one-third of cases can be resected. The long-term prognosis is extremely poor.

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