Common bile duct pressure in patients with common bile duct stones with or without acute suppurative cholangitis

A. Csendes, A. Sepulveda, P. Burdiles, I. Braghetto, J. Bastias, H. Schutte, J. C. Diaz, J. Yarmuch and F. Maluenda
Department of Surgery, J. J. Aguirre Hospital, University of Chile, Santiago.

Resting common bile duct pressure was measured in three groups of patients: group 1, 53 patients with gallstones but without common duct stones; group 2, 35 patients with common bile duct stones unaccompanied by cholangitis; and group 3, 36 patients with common duct stones and acute suppurative cholangitis. A significantly higher pressure in the common bile duct was documented in patients with cholangitis when compared with the other two groups. Twenty-four patients with cholangitis had common duct pressure values above 20 cm H2O, the maximal values of normal. Additionally, patients with cholangitis with pressure values over 30 cm H2O (nine patients) showed absence of green bile in the extrahepatic biliary tract, suggesting cessation of bile excretion into biliary duct. In all these cases, an impacted stone at the distal end of the common bile duct was documented.