A retrospective analysis of preoperative biliary imaging and ultrasound in 22 patients with surgically proven choledocholithiasis was performed. Ultrasound detected dilated ducts greater than 7 mm in 11 of 14 jaundiced patients (79%). Hepatobiliary imaging was able to detect either absent or delayed bowel visualization or prominent bile ducts in 13 of 14 jaundiced patients (93%). Of eight nonjaundiced patients, ultrasound showed dilated ducts in three (38%). Hepatobiliary imaging showed either absent bowel activity or prominent ducts in six of eight nonjaundiced patients (75%). Twenty of 22 patients had stones in the gallbladder that were detected by ultrasound, although only one patient had actual visualization of the common duct stone. Hepatobiliary imaging may show abnormalities in choledocholithiasis with normal ultrasound studies.
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