Diagnostic Accuracy of Endoscopic Ultrasonography Versus the Gold Standard Endoscopic Retrograde Cholangiopancreatography in Detecting Common Bile Duct Stones

Anwer, Mohsin; Asghar, Muhammad Sohaib; Rahman, Sheeraz; Kadir, Shanil; Yasmin, Farah; Mohsin, Dania; Jawed, Rumael; Memon, Gul Muhammad; Rasheed, Uzma; Hassan, Maira

doi:10.7759/cureus.12162

Cited by 11 publications

(8 citation statements)

References 24 publications

(24 reference statements)

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“…Ultrasound examination can clearly show and diagnose choledochal dilatation or biliary tract calculi, but may not show subtle structural abnormalities. In our case, the initial ultrasound examination did not observe repeated common bile duct [ 14 ]. The current gold standard for diagnosing biliary tract diseases is endoscopic retrocholangiopancreatography (ERCP), an invasive technique in which contrast agents are injected directly into the gallbladder or bile ducts, which can lead to serious complications, including pancreatitis and duodenal perforation.…”

Section: Discussionmentioning

confidence: 74%

A proposed feasible classification of common bile duct duplications based on a newly described variant and review of existing literature

et al. 2022

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Background Duplication of the common bile duct (CBD) is extremely rare among the anatomical variations in the biliary tract system, which presents a septum within the CBD or an accessory CBD. In our study, we report a rare case of duplication of the common bile duct combined congenital biliary dilatation.we present a rare case of a septum in the dilated biliary tract. Case presentation We reported a 5-year-old Asian girl who had history of repeated abdominal pain for 4 days and aggravated for 1 day. Magnetic resonance cholangiopancreatography (MRCP) examination revealed duplicated common bile duct (DCBD) malformation with congenital biliary dilatation and distal cholelithiasis. The patient underwent choledochal cyst resection and biliary tract reconstruction and abdominal cavity irrigation and drainage under general anesthesia. A septum was found within the common bile duct during the operation. The septum divided the extrahepatic bile duct into two parts connected to the left and right hepatic ducts respectively and the gallbladder is attached to the repeated right bile duct which was not previously reported in the literature. Conclusions We complement and adjust the classification of common bile duct duplication by reviewing the literature.

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Section: Discussionmentioning

confidence: 74%

A proposed feasible classification of common bile duct duplications based on a newly described variant and review of existing literature

et al. 2022

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“…This finding aligns with the study conducted by Bansal and colleagues, where they concluded that the mean age of patients was 47.9 ± 18.87 years, with 54.7% female sufferers in the majority, compared to 45.3% male, contradicting the outcomes of multiple studies [ 9 ]. In contrast, Anwer et al [ 10 ], Wang et al [ 11 ], Netinatsunton et al [ 12 ], and Khan et al [ 13 ] found that 51.2%, 58.4%, 41.1%, and 58.5% of males were more affected and showed a high tendency to develop CBD stones than females, with mean ages of 50, 59, 55, and 50 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Endoscopic Ultrasound and Transabdominal Ultrasound in the Detection of Gallbladder and Common Bile Duct Microlithiasis

Ul Hassan Khurshid,

Hinna,

Khan

et al. 2024

Cureus

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Objective: Endoscopic ultrasonography (EUS) is an emerging method with a wide range of potential uses in gastroenterology, including the detection of bile duct stones and the identification of early ductal alterations in suspected patients. This study was designed to compare the diagnostic yield of EUS and transabdominal ultrasound (TUS) in the detection of gallbladder and common bile duct (CBD) microlithiasis. Method: Patients with biliary colic with normal initial TUS were the subjects of this prospective study. EUS scan was performed on all recruited patients and linear endoscopes were used for the EUS examination. Cholecystectomy and histological analysis were done in patients within two weeks after EUS revealing cholelithiasis whereas the cases of CBD stone/microlithiasis were confirmed by endoscopic retrograde cholangiopancreatography (ERCP). The mean values of all hematological characteristics were independently determined for males and females and then compared using Student's t-test. For statistical significance, a p-value of 0.05 or below was used. Results: A total of 131 patients, including 77 females and 54 males, with a mean age of 38.41 ± 14.78 years were examined. All 78 (59.5%) individuals who had cholecystectomy were found to have gallstones or microlithiasis as successfully diagnosed by EUS. The sensitivity and specificity of EUS were 92.9% and 100%, respectively, for CBD stones and 98.8% and 100%, respectively, for the detection of gallbladder microlithiasis. The agreement between EUS and TUS was fair for CBD stones (κ = 0.214) and very weak for microlithiasis (κ = -0.093). Conclusion: EUS demonstrates a superior yield over TUS in detecting gallbladder stones and CBD microlithiasis, offering a more reliable diagnostic modality. Limitation: This was a single-center study.

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“…Rao Saad Ali Khan 1 , Laima Alam 2 , Zoya Ali Khan 3 , Uzair Ali Khan 4 pathologies with the added benefit of intervention if required. 5 Due to its invasive nature, ERCP is rarely preferred as the first choice of investigation and is usually preceded by MRCP or endoscopic ultrasound (EUS). 6 Endoscopic ultrasound (EUS) is an emerging minimally invasive technique with no risk of radiations or contrast related adverse effects but has limitations such as high cost, non-availability of the facility and trained personnel 7 and subsequently lack of local database.…”

Section: Original Articlementioning

confidence: 99%

Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool

Khan¹,

Alam²,

Khan³

et al. 2023

Pak J Med Sci

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Objective: To evaluate the diagnostic accuracy of different imaging modalities in patients with partial biliary obstruction with no obvious aetiology on initial imaging. Methods: This is a prospective single-centre cohort study carried out at Pak Emirates Military Hospital, Rawalpindi from June 2019 to June 2021 with non-probability consecutive sampling. Patients with ages 16 to 75 years, presenting with partial biliary obstruction and undetermined aetiology on initial imaging (TUS and MRCP) were enrolled. EUS was performed for each of these patients and the case was regarded as “true positive” or “true negative” if the findings of imaging modality correlated to those of ERCP. ROC curve, sensitivity, specificity, PPV, NPV and AUC (with 95% confidence interval) were drawn for all the diagnostic tools using SPSS V. 21. Results: A total of 65 patients were enrolled over a period of two years with male to female ratio of 1.4:1. Forty-four patients had an intermediate risk of choledocholithiasis upon preliminary evaluation whereas, 48(74%) of the participants had CBD calculi or sludge confirmed upon subsequent ERCP. Trans-abdominal ultrasound showed the lowest sensitivity (29.2%), specificity (85%), NPV 12% and PPV 93% for diagnosing CBD calculi. This was followed by MRCP with a sensitivity of 37.5%, specificity of 100%, NPV of 36.2% and PPV of 100%. EUS showed the maximum diagnostic accuracy with AUC of 1.0 and a 100% sensitivity and specificity when compared with ERCP as gold standard. Conclusion: EUS is superior to MRCP in terms of diagnostic accuracy as minimally invasive diagnostic tool and EUS superiority is particularly relevant in patients with intermediate risk of choledocholithiasis. doi: https://doi.org/10.12669/pjms.39.5.7280 How to cite this: Khan RSA, Alam L, Khan ZA, Khan UA. Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7280 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Diagnostic Accuracy of Endoscopic Ultrasonography Versus the Gold Standard Endoscopic Retrograde Cholangiopancreatography in Detecting Common Bile Duct Stones

Cited by 11 publications

References 24 publications

A proposed feasible classification of common bile duct duplications based on a newly described variant and review of existing literature

A proposed feasible classification of common bile duct duplications based on a newly described variant and review of existing literature

Comparison of Endoscopic Ultrasound and Transabdominal Ultrasound in the Detection of Gallbladder and Common Bile Duct Microlithiasis

Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool

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