Complex Cystic Duct is Associated With Cholelithiasis

The relationship between complex cystic ducts and cholelithiasis has seldom been investigated quantitatively. Thus we attempted a retrospective survey on two case series with and without cholelithiasis in a university hospital. A total of 500 patients who underwent endoscopic retrograde cholangiography were reviewed, 250 of whom had cholelithiasis and another 250 no gallstones. They were sampled at random during the period from 1979 through 1993. Parameters including the length, inner diameter and configuration of the cystic duct, and the angle formed by the cystic duct, and the axis of the gallbladder were compared between the groups with or without cholelithiasis. The patients with gallstones has significantly (p < 0.001) longer and narrower cystic ducts (a mean of 48 mm and 4 mm in length and diameter, respectively) than did those without stones (a mean of 28 mm and 7 mm, respectively). Moreover, patients with gallstones showed a significantly (p < 0.001) more acute angle between the gallbladder and the cystic duct than those without (a mean angle of 84 degrees and 119 degrees respectively). The overall frequency of the disfigurements of the cystic duct was significantly higher in the group with gallstones (99%) than in the group without (29%). The results therefore suggested that complex cystic ducts are associated with cholelithiasis.