Related Experiment Video
Updated: May 4, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Common bile duct dilatation in drug users with chronic hepatitis C is associated with current methadone use
Stije J Leopold1, Bart P X Grady, Catharina E A Lindenburg
1From the Department of Research (SJL, BPXG, CEAL, MP), Cluster Infectious Diseases, Public Health Service Amsterdam, Amsterdam, the Netherlands; Center of Infectious Diseases and Immunology Amsterdam (BPXG, CEAL, MP) and Department of Gastroenterology and Hepatology (UB, CJW), Academic Medical Center, Amsterdam, the Netherlands; and Department of Internal Medicine (MP), Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, the Netherlands.
Objectives:
Dilatation of the common bile duct (CBD) can be an ominous sign for malignancy of the pancreatobiliary tract; however, it has also been described as a presumably harmless side effect of opioid use. We investigated the prevalence and determinants of CBD dilatation among drug users receiving methadone maintenance therapy in the Netherlands.
Methods:
A cross-sectional study was conducted in a prospectively studied and well-defined cohort of drug users with chronic hepatitis C virus infection, attending the Public Health Service of Amsterdam, the Netherlands. Patients underwent abdominal ultrasonography as part of pretreatment screening. A multivariable logistic regression model was used to analyze potential demographic and drug use-related determinants of radiological CBD dilatation.
Results:
Between September 2004 and December 2011, 222 hepatitis C virus-infected drug users were evaluated. Dilatation of the CBD was found in 50 of 222 patients (22.5%), with a median diameter of 8.0 mm (interquartile range, 7.0 to 10.0; n = 43). Dilatation was associated with current use of methadone (adjusted odds ratio = 20.50; 95% confidence interval, 2.79 to 2.61 × 10(3)), independent of the current methadone dose, and with age per 10-year increase (adjusted odds ratio = 1.68; 95% confidence interval, 1.06 to 2.71). Regular use of heroin in the 6 months before ultrasonography was not found to be associated with dilatation.
Conclusions:
Dilatation of the CBD is common in drug users under methadone treatment and seems to be a harmless side effect of opioid agonists.
More Related Videos
Related Concept Videos
Hepatic Drug Excretion: Influencing Factors
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test
Hepatic Drug Excretion: Enterohepatic Cycling
Post-release drugs and metabolites can be reabsorbed into the body from the intestine. For conjugated metabolites like glucuronides, reabsorption requires enzymatic hydrolysis by intestinal microflora. This...
Effect of Hepatic Disease on Pharmacokinetics: Drug Dosing and Hepatic Blood Flow
Chronic Pancreatitis II: Collaborative Care
Assessment:
Chronic Pancreatitis II: Pathophysiology

