IS BILIARY LITHOGENESIS AFFECTED BY LENGTH AND IMPLANTATION OF CYSTICDUCT - STUDY OF 270 PATIENTS WITH ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY

The gallbladder seems to play an important role in lithogenesis. Moreo ver, the morphology and the implantation of the cystic duct may also i nfluence this process. Our purpose was to evaluate if the length and t he implantation of the cystic duct may affect the formation of gallsto nes. Between April 1992 and March 1994, 270 patients who underwent end oscopic retrograde cholangiopancreatography were included in the study , and the radiological length of the cystic duct was carefully recorde d. Patients were divided into two groups: I, absence of lithiasis: 113 patients (65 men, 48 women); and II, gallbladder lithiasis or lithias is in the common bile duct with or without gallbladder lithiasis: 157 patients (73 men, 84 women). A statistically significant difference wa s observed among the two groups regarding the insertion of the cystic duct: implantation on the left side of the common bile duct represente d a risk factor of lithiasis. The length of the cystic duct was not di rectly implicated. Hypokinesis of the gallbladder is currently recogni zed as being a major factor in the initial steps of lithogenesis, but the implantation of the cystic duct can play an important role by incr easing cystic duct resistance and causing a reduced washout effect of the gallbladder contents, including cholesterol crystals.