Incidental biliary dilation in the era of the opiate epidemic:High prevalence of biliary dilation in opiate users evaluated in the Emergency Department  

作　　者：Monique T Barakat Subhas Banerjee 

机构地区：[1]Divisions of Adult and Pediatric Gastroenterology and Hepatology,Stanford University Medical Center,Stanford,CA 94305,United States [2]Division of Gastroenterology and Hepatology,Stanford University Medical Center,Stanford,CA 94304,United States

出　　处：《World Journal of Hepatology》2020年第12期1289-1298,共10页世界肝病学杂志（英文版）（电子版）

摘　　要：BACKGROUND Biliary dilation is frequently related to obstruction;however,non-obstructive factors such as age and previous cholecystectomy have also been reported.In the past two decades there has been a dramatic increase in opiate use/dependence and utilization of cross-sectional abdominal imaging,with increased detection of biliary dilation,particularly in patients who use opiates.AIM To evaluate associations between opiate use,age,cholecystectomy status,ethnicity,gender,and body mass index utilizing our institution’s integrated informatics platform.METHODS One thousand six hundred and eighty-five patients(20%sample)presenting to our Emergency Department for all causes over a 5-year period(2011-2016)who had undergone cross-sectional abdominal imaging and had normal total bilirubin were included and analyzed.RESULTS Common bile duct(CBD)diameter was significantly higher in opiate users compared to non-opiate users(8.67 mm vs 7.24 mm,P<0.001)and in patients with a history of cholecystectomy compared to those with an intact gallbladder(8.98 vs 6.72,P<0.001).For patients with an intact gallbladder who did not use opiates(n=432),increasing age did not predict CBD diameter(r^2=0.159,P=0.873).Height weakly predicted CBD diameter(r^2=0.561,P=0.018),but weight,body mass index,ethnicity and gender did not.CONCLUSION Opiate use and a history of cholecystectomy are associated with CBD dilation in the absence of an obstructive process.Age alone is not associated with increased CBD diameter.These findings suggest that factors such as opiate use and history of cholecystectomy may underlie the previously-reported association of advancing age with increased CBD diameter.Further prospective study is warranted.

关 键 词：Biliary dilation OPIATE NARCOTIC Endoscopic ultrasound Endoscopic retrograde cholangiopancreatography Bile duct 

分 类 号：R969[医药卫生—药理学]