Efficacy of Endoscopic Ultrasonography in Evaluation of Undetermined Etiology of Common Bile Duct Dilatation on Abdominal Ultrasonography.
BACKGROUND The cause of common bile duct (CBD) dilatation cannot be determined by imaging modalities in many patients. The aim of this study was to assess the value of endoscopic ultrasonography (EUS) in detecting the cause of CBD dilatation in patients in whom ultrasonography could not demonstrate...
| Publicado en: | Middle East Journal of Digestive Diseases Vol. 8; no. 4; pp. 267 - 273 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Iranian Association of Gastroenterology & Hepatology
Oct2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=119171704&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 119171704 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20085230 BG4K jtl: Middle East Journal of Digestive Diseases issn: 20085230 maglogo: N pubinfo: dt: Oct2016 vid: 8 iid: 4 pid: 70725 pub: Iranian Association of Gastroenterology & Hepatology artinfo: ui: 119171704 119171704 119171704 10.15171/mejdd.2016.35 119171704 ppf: 267 ppct: 6 formats: fmt: @attributes: type: P tig: atl: Efficacy of Endoscopic Ultrasonography in Evaluation of Undetermined Etiology of Common Bile Duct Dilatation on Abdominal Ultrasonography. aug: au: Sotoudehmanesh, Rasoul Nejati, Naimeh Farsinejad, Maryam Kolahdoozan, Shadi affil: Professor. Digestive Disease Research Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran sug: subj: Endosonography Dilatation and Curettage Abdomen Ultrasonography Treatment Outcomes Bile Duct Neoplasms Ultrasonography Human Prospective Studies Cholangiopancreatography, Endoscopic Retrograde Biopsy, Needle After Care Cholelithiasis Diagnosis Endoscopy, Gastrointestinal Chemoradiotherapy Male Female Aged Adult Liver Function Tests Cholecystectomy Duodenal Neoplasms Diagnosis Cholangiocarcinoma Sensitivity and Specificity Predictive Validity Neoplasm Staging Aged: 65+ years Adult: 19-44 years Male Female ab: BACKGROUND The cause of common bile duct (CBD) dilatation cannot be determined by imaging modalities in many patients. The aim of this study was to assess the value of endoscopic ultrasonography (EUS) in detecting the cause of CBD dilatation in patients in whom ultrasonography could not demonstrate the cause of dilation. METHODS Prospectively, 152 consecutive patients who were referred for evaluation of dilated CBD (diameter ≥7 mm) of undetermined origin by ultrasonography were included in this study. All the patients underwent EUS. Final diagnoses were determined by using endoscopic retrograde cholangiopancreatography (ERCP), EUS-guided fine needle aspiration (FNA), surgical exploration, or follow-up for at least 10 months. Patients with choledocholithiasis were referred for ERCP and sphincterotomy, and patients with operable tumors were referred for surgery. Patients with inoperable tumors underwent biliary stenting with or without chemoradiotherapy. RESULTS 152 patients (54% female) with dilated CBD were included. Mean (±SD) age of the patients was 60.4 (±17.3) years. The mean CBD diameter for all study group in transabdominal ultrasonography and EUS were 11.7 millimeter and 10.1 millimeter, respectively. Most of the patients with dilated CBD and abnormal liver function test (LFT) had an important finding in EUS and follow-up diagnosis including peri-ampullary tumors. Mean diameter of CBD in patients with and without abnormal LFT were 10.5 IU/L and 12.1 IU/L, respectively. Final diagnoses included choledocholithiasis in 32 (21.1%), passed CBD stone in 35 (23%), opium-induced CBD dilation in 14 (9.2%), post-cholecystectomy states in 20 (13.1%), ampullary adenoma/carcinoma in 15 (15.8%), cholangiocarcinoma in 14 (9.2%), and pancreatic head cancer in 9 (5.9%) patients. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of EUS for patients with abnormal EUS were 89.5%, 100.0%, 100.0%, 91.2%, and 90.9%, respectively. CONCLUSION After diagnosis of CBD dilation by transabdominal ultrasonography, EUS may be a reasonable choice for determining the etiology of dilated CBD and tumor staging. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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