[Ultrasonographic diagnosis of choledocholithiasis]

In recent years various authors have shown more than a threefold increase in us diagnosis of choledocholithiasis. To verify this premise, we examined prospectively with ultrasound, from January, 1987, to December 1990, 107 cases, all confirmed by subsequent intraoperative cholangiography. The ultrasound diagnosis was positive in 55 cases (51,5%), negative in 52, and the percentage of positivity was higher in prepared patients (59%) than in the emergency ones. Of the 55 positive cases, 54 showed common bile duct dilatation (more than 6 mm.), and only 1 had a normal diameter. Also our results show a marked improvement of ultrasound sensitivity in this kind of diagnosis, in comparison with previous series, depending on the continuous improvement in technology. Anyway some limiting factors remain, such as sonologist experience, poor patient intestinal preparation, absence of common bile duct dilatation.