Endoscopic ultrasonography for diagnosing choledocholithiasis: a prospective comparative study with ultrasonography and computed tomography☆,☆☆,★
Section snippets
PATIENTS AND METHODS
Between 1993 and 1995, we studied a prospective series of 155 consecutive patients (70 men and 85 women; age range, 21 to 91 years, mean, 61.2 years) who were referred for ERCP because of suspected choledocholithiasis. All patients met at least one of the following criteria for ERCP; epigastric or right upper quadrant pain with fever (75 patients), jaundice (81 patients), abnormal blood liver chemistry test (102 patients), a dilated common bile duct (>7 mm in diameter) on conventional
RESULTS
No complications were encountered after EUS in 37 patients who underwent EUS and ERCP on separate days. However, 3 of 118 patients who underwent both EUS and ERCP on the same day had minor complications: mild acute pancreatitis (2 patients) and acute cholangitis (1 patient). These complications were attributed to ERCP.
In 142 of 155 patients, ERCP clearly depicted the entire extrahepatic bile duct. Of 142 patients, 51 had common bile duct stones demonstrated by ERCP, which were subsequently
DISCUSSION
The present prospective study showed that EUS depicted the whole length of the extrahepatic bile duct in 96% of the patients and that EUS detected common bile duct stones in 96% of the patients.
The sensitivity (63%) of ultrasonography for choledocholithiasis in our series was comparable to that previously reported (55% to 75%3, 4, 5, 6). The low sensitivity of ultrasonography is partly due to abdominal fat or overlying bowel gas obscuring images of the common bile duct, especially of the distal
References (15)
- et al.
Diagnosis of choledocholithiasis by endoscopic ultrasonography
Gastroenterology
(1994) - et al.
Complications of endoscopic retrograde cholangiopancreatography and therapy
- et al.
Transhepatic cholangiography: complications and use patterns of the fine needle technique. A multi-institutional survey
Radiology
(1980) - et al.
Improved visualization of choledocholithiasis by sonography
AJR Am J Roentgenol
(1984) - et al.
Improved sonographic visualization of choledocholithiasis
J Clin Ultrasound
(1987) Ultrasound diagnosis of choledocholithiasis: a reappraisal
Radiology
(1986)Ultrasound diagnosis of choledocholithiasis
Semin Ultrasound CT MR
(1987)
Cited by (0)
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From the First Department of Surgery, Kyorin University School of Medicine, Tokyo, Japan.
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Reprint requests: Masanori Sugiyama, MD, First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181, Japan.
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