Diagnostic accuracy of endoscopic ultrasound in evaluation of patients with obstructive jaundice: single-center experience

Bakr, Shereen Abou; Elessawy, Hagar; Ghaly, S.; Elezz, Muhammed Abo; Farahat, A; Zaghloul, Mariam

doi:10.1186/s43066-022-00179-y

Cited by 3 publications

(3 citation statements)

References 19 publications

(22 reference statements)

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“…Choledocholithiasis, can grow due to a variety of diseases, including stricture, cholangiocarcinoma, periampullary diverticulum, pancreatic head mass, sphincter of Oddi dysfunction, papillary stenosis, and others. A dilated CBD may be indicative of underlying biliary pathology, although it can also occur in older people or those who have undergone cholecystectomy without any pathology (7,13) . The individuals with CBD dilatation must therefore be assessed further in order to rule out any sinister underlying causes.…”

Section: Discussionmentioning

confidence: 99%

“…Since MRCP and EUS are both superior diagnostic techniques for pancreaticbiliary diseases, it is crucial to compare their diagnostic efficacy. Most of the investigations have showed strong diagnostic performance of these two modalities with no significant difference in the diagnostic yield between these two modalities (13) . Hence, in individuals with equivocal MRCP, EUS would be able to identify any abnormality provided both modalities have equivalent diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic Value of Endoscopic Ultrasonography (EUS) in Unexplained Common Bile Duct Dilatation

lotfy¹,

Refaey²,

Elshamy³

et al. 2023

The Egyptian Journal of Hospital Medicine

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Background: Many etiologies can be behind common bile duct dilatation that is undiagnosed, such as pancreatic and periampullary tumors, choledocholithiasis, or an inflammatory condition as stenosis. Endoscopic ultrasound (EUS) may have a major diagnostic value in detecting etiologies of dilated CBD undetected by other non-invasive modalities.Objectives: This study aimed to determine whether endoscopic ultrasonography is helpful in detecting a common bile duct dilatation that isn't clear. Methods: This study was conducted on 67 participants who had unexplained CBD dilatation at Tropical Medicine Department, Zagazig University. Every patient underwent TUS, CT, MRCP and EUS. Findings of EUS were seen and verified by ERCP, surgery, or a biopsy that revealed cancer. Those who had normal results underwent three months of clinical monitoring. Results: 77.6% and 59.7% of patients underwent US and CT respectively prior to MRCP and EUS. By MRCP, 82.1% of patients were normal, 11.9% had stone, while 3% had CBD mass and 3% had stricture. While by using EUS, 50.7% were normal, 22.4% had stone, while 8.9% had ampullary lesion. Post EUS outcome 37 (55.2%) of patients had only medical follow up while 22.4% had stone extracted by ERCP, 6 patients (8.9%) had sphincterotomy and biopsy from lesions, 4 cases of them had adenocarcinoma, the other 2 cases had adenoma and 2 cases had CBD stricture treated by sphincterotomy and stent dilatation. 2 cases of pancreatic cancer underwent Whipple operation. EUS denied results of MRCP in 25 cases. Conclusion: EUS has a very useful role in the diagnostic work up for patients with unexplained CBD dilatation with or without symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Endoscopic Ultrasonography (EUS) in Unexplained Common Bile Duct Dilatation

lotfy¹,

Refaey²,

Elshamy³

et al. 2023

The Egyptian Journal of Hospital Medicine

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“…1 Transabdominal ultrasonography is universally employed as the first diagnostic technique for detecting gastrointestinal pathologies but, unfortunately, has low sensitivity for detecting small common bile duct (CBD) stones and sludge 2 and could achieve definitive diagnosis in only one third of the cases. 3 Similarly, magnetic retrograde cholangio-pancreatogram (MRCP) has a high sensitivity and specificity for detecting choledocholithiasis and strictures but the sensitivity decreases when stone diameter reaches ≤5mm. 4 Endoscopic retrograde cholangio-pancreatography (ERCP) is the gold standard tool for detecting CBD…”

Section: Introductionmentioning

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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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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Diagnostic accuracy of endoscopic ultrasound in evaluation of patients with obstructive jaundice: single-center experience

Cited by 3 publications

References 19 publications

Diagnostic Value of Endoscopic Ultrasonography (EUS) in Unexplained Common Bile Duct Dilatation

Diagnostic Value of Endoscopic Ultrasonography (EUS) in Unexplained Common Bile Duct Dilatation

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

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

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