The insensitivity of sonography in the detection of choledocholithiasis

To determine the sensitivity of sonography in the detection of choledocholithiasis, the sonograms of 138 patients with surgically proven common bile duct stones were reviewed. A definite diagnosis of choledocholithiasis could be made on the basis of the sonograms in 22% of cases. Overall, 23% had common ducts of normal caliber (less than or equal to 7 mm diam) and 23% had normal total bilirubin levels at the time of the examination. Although a sonographic diagnosis of choledocholithiasis provides important information for the surgeon, the method is not sufficiently sensitive to serve as a definitive preoperative test for common bile duct stones.