{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T15:02:04Z","timestamp":1791298924074,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Ultrasound Medicine"],"abstract":"\n Objectives<\/jats:title>\n Choledocholithiasis often coexists with symptomatic cholelithiasis, and early detection is crucial to prevent complications. In these patients, the common bile duct (CBD) may appear non\u2010dilated on ultrasonography (US). Studies on the temporal evolution of CBD measurements and corresponding bilirubin levels are currently lacking. Herein, we aim to evaluate the temporal evolution and correlation of CBD\/intrahepatic duct (IHD) dilatation with serum bilirubin levels in patients with choledocholithiasis.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n In this single\u2010center prospective study, we included 46 patients with acute right upper quadrant pain, sonographically confirmed cholelithiasis and MRCP\/ERCP confirmed choledocholithiasis. CBD\/IHD US measurements and serum total\/direct bilirubin levels were obtained at <24 (t1), 24\u201348 (t2), and 48\u201372\u2009hours (t3). Serial CBD\/IHD diameters were correlated with bilirubin concentrations. Statistical significance was set at\n p<\/jats:italic>\n \u2009<\u2009.01.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Prevalence of CBD dilatation increased from 34.8% at t1 to 69.6% at t2 and 95.7% at t3. Mean CBD diameters increased from 5.7\u2009\u00b1\u20092.3\u2009mm to 8.2\u2009\u00b1\u20092.7\u2009mm and 12.1\u2009\u00b1\u20092.5\u2009mm (\n p<\/jats:italic>\n \u2009<\u2009.0001). IHD dilatation incidence increased from 2.1 to 19.6% and 78.3%. Total\/direct bilirubin levels progressed between all time\u2010points, with the greatest increase between t1 and t3 (\n p<\/jats:italic>\n \u2009=\u2009.0003\/\n p<\/jats:italic>\n \u2009=\u2009.0006). Sensitivity of CBD dilatation for diagnosing choledocholithiasis was 34.8, 69.6, and 95.7% increasing to 56.5%\/78.3%, 87%\/91.3% and 95.7%\/95.7% when combined with total\/direct bilirubin across t1, t2, and t3, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In patients with choledocholithiasis, emergency US may be false\u2010negative. Serial US assessment of CBD diameter, particularly when combined with bilirubin trends, substantially improves diagnostic sensitivity. Repeat US and laboratory investigations within up to 3\u2009days are supported for appropriate patient management.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/jum.70487","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:39:28Z","timestamp":1789709968000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Temporal Changes in Biliary Duct Diameter with Correlated Bilirubin Levels in Confirmed Choledocholithiasis: A Prospective 3 Time\u2010Point Observational Ultrasound Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-6700-9037","authenticated-orcid":false,"given":"Maria","family":"Giannaki","sequence":"first","affiliation":[{"name":"Department of Medical Imaging University Hospital of Heraklion Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2731-933X","authenticated-orcid":false,"given":"Michail","family":"Klontzas","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging University Hospital of Heraklion Heraklion Greece"},{"name":"Department of Radiology School of Medicine, University of Crete Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5937-2111","authenticated-orcid":false,"given":"Iraklis","family":"Perysinakis","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology University Hospital of Heraklion Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Spanakis","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging University Hospital of Heraklion Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5281-475X","authenticated-orcid":false,"given":"Maria","family":"Raissaki","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging University Hospital of Heraklion Heraklion Greece"},{"name":"Department of Radiology School of Medicine, University of Crete Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5509-687X","authenticated-orcid":false,"given":"Evangelia E.","family":"Vassalou","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging University Hospital of Heraklion Heraklion Greece"},{"name":"Department of Radiology School of Medicine, University of Crete Heraklion Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"4536","DOI":"10.3748\/wjg.v27.i28.4536","article-title":"Management of cholelithiasis with choledocholithiasis: endoscopic and surgical approaches","volume":"27","author":"Cianci P","year":"2021","journal-title":"World J Gastroenterol"},{"key":"e_1_2_8_3_1","first-page":"1","article-title":"The role of endoscopy in the evaluation of suspected choledocholithiasis","volume":"71","author":"Committee ASoP","year":"2010","journal-title":"Gastrointest Endosc"},{"key":"e_1_2_8_4_1","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1038\/ajg.2016.517","article-title":"ACG clinical guideline: evaluation of abnormal liver chemistries","volume":"112","author":"Kwo PY","year":"2017","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_8_5_1","doi-asserted-by":"crossref","first-page":"S126","DOI":"10.1016\/j.jacr.2019.02.012","article-title":"ACR appropriateness criteria((R)) jaundice","volume":"16","author":"Expert Panel on Gastrointestinal I","year":"2019","journal-title":"J Am Coll Radiol"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.amjsurg.2013.10.014","article-title":"Can ultrasound common bile duct diameter predict common bile duct stones in the setting of acute cholecystitis?","volume":"207","author":"Boys JA","year":"2014","journal-title":"Am J Surg"},{"key":"e_1_2_8_7_1","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1097\/SLE.0b013e31818a6685","article-title":"The diameter of common bile duct does not predict the cause of extrahepatic cholestasis","volume":"19","author":"Karvonen J","year":"2009","journal-title":"Surg Laparosc Endosc Percutan Tech"},{"key":"e_1_2_8_8_1","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1186\/s12876-015-0392-1","article-title":"Is preoperative MRCP necessary for patients with gallstones? An analysis of the factors related to missed diagnosis of choledocholithiasis by preoperative ultrasound","volume":"15","author":"Qiu Y","year":"2015","journal-title":"BMC Gastroenterol"},{"key":"e_1_2_8_9_1","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1308\/003588414X13814021678033","article-title":"Serology and ultrasound for diagnosis of choledocholithiasis","volume":"96","author":"Isherwood J","year":"2014","journal-title":"Ann R Coll Surg Engl"},{"key":"e_1_2_8_10_1","doi-asserted-by":"crossref","first-page":"919","DOI":"10.3390\/diagnostics15070919","article-title":"Ultrasound of bile ducts\u2010an update on measurements, reference values, and their influencing factors","volume":"15","author":"Lucius C","year":"2025","journal-title":"Diagnostics (Basel)"},{"key":"e_1_2_8_11_1","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1016\/j.gie.2018.11.017","article-title":"Preoperative predictors of choledocholithiasis in patients presenting with acute calculous cholecystitis","volume":"89","author":"Chisholm PR","year":"2019","journal-title":"Gastrointest Endosc"},{"key":"e_1_2_8_12_1","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1159\/000448917","article-title":"The efficacy of clinical predictors for patients with intermediate risk of choledocholithiasis","volume":"94","author":"Kang J","year":"2016","journal-title":"Digestion"},{"key":"e_1_2_8_13_1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/den.12506","article-title":"Prospective assessment of consensus criteria for evaluation of patients with suspected choledocholithiasis","volume":"28","author":"Sethi S","year":"2016","journal-title":"Dig Endosc"},{"key":"e_1_2_8_14_1","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1007\/s00464-001-0005-7","article-title":"Practical recommendations for the prediction and management of common bile duct stones in patients with gallstones","volume":"15","author":"Kama NA","year":"2001","journal-title":"Surg Endosc"},{"key":"e_1_2_8_15_1","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/00000658-199407000-00006","article-title":"Useful predictors of bile duct stones in patients undergoing laparoscopic cholecystectomy. McGill Gallstone Treatment Group","volume":"220","author":"Barkun AN","year":"1994","journal-title":"Ann Surg"},{"key":"e_1_2_8_16_1","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1016\/j.amjsurg.2018.06.011","article-title":"Total bilirubin trend as a predictor of common bile duct stones in acute cholecystitis and symptomatic cholelithiasis","volume":"217","author":"Gillaspie DB","year":"2019","journal-title":"Am J Surg"},{"key":"e_1_2_8_17_1","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.2214\/AJR.18.20613","article-title":"Bilirubin correlation may preclude MRCP in acute cholecystitis patients with normal common bile duct diameter","volume":"212","author":"Chen JE","year":"2019","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_2_8_18_1","doi-asserted-by":"crossref","first-page":"5877","DOI":"10.3748\/wjg.v19.i35.5877","article-title":"Non\u2010invasive assessment of choledocholithiasis in patients with gallstones and abnormal liver function","volume":"19","author":"Al\u2010Jiffry BO","year":"2013","journal-title":"World J Gastroenterol"},{"key":"e_1_2_8_19_1","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/j.jacr.2013.05.022","article-title":"Managing incidental findings on abdominal and pelvic CT and MRI, part 4: white paper of the ACR incidental findings committee II on gallbladder and biliary findings","volume":"10","author":"Sebastian S","year":"2013","journal-title":"J Am Coll Radiol"},{"key":"e_1_2_8_20_1","doi-asserted-by":"crossref","DOI":"10.2214\/AJR.23.29671","article-title":"Biliary duct dilatation: AJR expert panel narrative review","volume":"222","author":"Ludwig DR","year":"2024","journal-title":"AJR Am J Roentgenol"},{"key":"e_1_2_8_21_1","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1148\/radiographics.20.4.g00jl23939","article-title":"MR cholangiopancreatography of bile and pancreatic duct abnormalities with emphasis on the single\u2010shot fast spin\u2010echo technique","volume":"20","author":"Vitellas KM","year":"2000","journal-title":"Radiographics"},{"key":"e_1_2_8_22_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s13244-011-0129-9","article-title":"Magnetic resonance cholangiopancreatography: the ABC of MRCP","volume":"3","author":"Griffin N","year":"2012","journal-title":"Insights Imaging"},{"key":"e_1_2_8_23_1","doi-asserted-by":"crossref","DOI":"10.3389\/fmedt.2023.946555","article-title":"Comparison of MRCP and ERCP in the evaluation of common bile duct and pancreatic duct pathologies","volume":"5","author":"Kumar A","year":"2023","journal-title":"Front Med Technol"},{"key":"e_1_2_8_24_1","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1177\/1535370220966767","article-title":"Etiological classification and treatment strategies for secondary bile duct dilatation","volume":"246","author":"Lv Y","year":"2021","journal-title":"Exp Biol Med (Maywood)"},{"key":"e_1_2_8_25_1","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1002\/jhbp.931","article-title":"Common bile duct pressure in patients with and without cholelithiasis: a case\u2010control study","volume":"28","author":"Beltran MA","year":"2021","journal-title":"J Hepatobiliary Pancreat Sci"}],"container-title":["Journal of Ultrasound in Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.70487","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/jum.70487","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jum.70487","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T05:39:31Z","timestamp":1789709971000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jum.70487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,17]]},"references-count":24,"alternative-id":["10.1002\/jum.70487"],"URL":"https:\/\/doi.org\/10.1002\/jum.70487","archive":["Portico"],"relation":{},"ISSN":["0278-4297","1550-9613"],"issn-type":[{"value":"0278-4297","type":"print"},{"value":"1550-9613","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,17]]},"assertion":[{"value":"2026-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"jum.70487"}}