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Review

Ultrasound of Bile Ducts—An Update on Measurements, Reference Values, and Their Influencing Factors

by
Claudia Lucius
1,
Anja Flückiger
2,
Jennifer Meier
3,
Kathleen Möller
4,
Christian Jenssen
5,6,
Barbara Braden
7,8,
Michael Kallenbach
9,
Benjamin Misselwitz
10,11,
Christian Nolsøe
12,13,
Michael Sienz
14,
Constantinos Zervides
15 and
Christoph Frank Dietrich
2,*
1
Outpatient Department of Gastroenterology, IBD Centre Helios Hospital Berlin Buch, 13125 Berlin, Germany
2
Department General Internal Medicine (DAIM), Hospitals Hirslanden Bern Beau Site, Salem and Permanence, 3013 Bern, Switzerland
3
Department Allgemeine Innere Medizin, Kliniken Hirslanden, Beau Site, Salem und Permanence, 3013 Bern, Switzerland
4
Medical Department I/Gastroenterology, SANA Hospital Lichtenberg, 10365 Berlin, Germany
5
Department for Internal Medicine, Krankenhaus Märkisch Oderland, 15344 Strausberg, Germany
6
Brandenburg Institute for Clinical Ultrasound (BICUS) at Brandenburg Medical University, 16816 Neuruppin, Germany
7
Translational Gastroenterology Unit, Oxford University Hospitals, Oxford OX3 9DU, UK
8
Medical Department B, University Muenster, 48149 Muenster, Germany
9
Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Düsseldorf, 40225 Dusseldorf, Germany
10
Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, 3012 Bern, Switzerland
11
Medizinische Klinik und Poliklinik II, LMU München, 80539 München, Germany
12
Center for Surgical Ultrasound, Department of Surgery, Zealand University Hospital, 4600 Køge, Denmark
13
Institute for Clinical Medicine, Denmark University of Copenhagen, 1172 Kobenhavn, Denmark
14
Benedictine Congregation of St. Ottilien, St. Benedict Hospital Ndanda, Ndanda, Mtwara Region, Tanzania
15
CZMH Medical Physics and Dosimetry Services Ltd., Limassol, Cyprus
 
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*
Author to whom correspondence should be addressed.
Diagnostics 2025, 15(7), 919; https://doi.org/10.3390/diagnostics15070919
Submission received: 14 February 2025 / Revised: 24 March 2025 / Accepted: 27 March 2025 / Published: 2 April 2025
(This article belongs to the Special Issue Imaging Diagnosis in Abdomen, 2nd Edition)
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Abstract

Objective: To provide an overview of the technique and normal values of ultrasound studies of the bile system based on the published literature. Methods: A literature search for ultrasound studies with measurements of the bile ducts in healthy subjects was performed. Relevant data published between 1975 and end of 2024 were extracted, discussed, and complemented with the own experiences of the authors. The clinical implications are presented and discussed. Results: For the diameter of the common bile duct, reference values between 5 and 9 mm have been published. The main influencing factors are age and history of cholecystectomy, and other factors to be considered are discussed here. The cut-off for the common bile duct wall is set at 1.5 mm. The literature on measurements of intrahepatic bile ducts is scarce. A diameter of <2–3 mm can be considered normal. The method of ultrasound examination is presented here, as well as a comparison with other imaging methods and their clinical implications. Conclusions: Standardized measurement techniques and normal values in the context of influencing factors are crucial for the ultrasound examination of the bile system.
Keywords: reference values; common bile duct; diameters; measurement; cystic duct; bile duct drainage reference values; common bile duct; diameters; measurement; cystic duct; bile duct drainage

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MDPI and ACS Style

Lucius, C.; Flückiger, A.; Meier, J.; Möller, K.; Jenssen, C.; Braden, B.; Kallenbach, M.; Misselwitz, B.; Nolsøe, C.; Sienz, M.; et al. Ultrasound of Bile Ducts—An Update on Measurements, Reference Values, and Their Influencing Factors. Diagnostics 2025, 15, 919. https://doi.org/10.3390/diagnostics15070919

AMA Style

Lucius C, Flückiger A, Meier J, Möller K, Jenssen C, Braden B, Kallenbach M, Misselwitz B, Nolsøe C, Sienz M, et al. Ultrasound of Bile Ducts—An Update on Measurements, Reference Values, and Their Influencing Factors. Diagnostics. 2025; 15(7):919. https://doi.org/10.3390/diagnostics15070919

Chicago/Turabian Style

Lucius, Claudia, Anja Flückiger, Jennifer Meier, Kathleen Möller, Christian Jenssen, Barbara Braden, Michael Kallenbach, Benjamin Misselwitz, Christian Nolsøe, Michael Sienz, and et al. 2025. "Ultrasound of Bile Ducts—An Update on Measurements, Reference Values, and Their Influencing Factors" Diagnostics 15, no. 7: 919. https://doi.org/10.3390/diagnostics15070919

APA Style

Lucius, C., Flückiger, A., Meier, J., Möller, K., Jenssen, C., Braden, B., Kallenbach, M., Misselwitz, B., Nolsøe, C., Sienz, M., Zervides, C., & Dietrich, C. F. (2025). Ultrasound of Bile Ducts—An Update on Measurements, Reference Values, and Their Influencing Factors. Diagnostics, 15(7), 919. https://doi.org/10.3390/diagnostics15070919

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