Diagnostic accuracy of EUS compared with MRCP in detecting choledocholithiasis: a meta-analysis of diagnostic test accuracy in head-to-head studies

Meeralam, Yaser kh.; Alshammari, Khalil; Yaghoobi, Mohammad

doi:10.1016/j.gie.2017.06.009

Cited by 120 publications

(87 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although this was not the primary focus of our study, our data show that the accuracy of IOC is very good, with overall and categorized sensitivities and specificities of >90%. EUS and MRCP show similar accuracy in the literature, with respective sensitivities of 91–99% and 80–93%, and specificities of 83–94% and 87–96% [ 25 – 27 ]. Even though the positive predictive value of IOC in our study is only around 50%, resulting in a number of unnecessary postoperative procedures (a total of 38 for 578 patients), its negative predictive value is nearly 100%, making it an excellent, safe and inexpensive investigation to exclude CBD stones.…”

Section: Discussionsupporting

confidence: 54%

Feasibility, benefit and risk of systematic intraoperative cholangiogram in patients undergoing emergency cholecystectomy

et al. 2018

View full text Add to dashboard Cite

BackgroundThe role of intraoperative cholangiogram (IOC) during cholecystectomy is debated. The aim of the present study was to evaluate the feasibility, benefit and risk of performing systematic IOC in patients undergoing cholecystectomy for acute gallstone-related disease.MethodsBetween July 2013 and January 2015, all patients admitted for an acute gallstone-related condition and undergoing same-hospital-stay cholecystectomy were prospectively followed. IOC was systematically attempted and predictors of IOC failure were analyzed.ResultsAmong the 581 enrolled patients, IOC was deliberately not performed in 3 cases. IOC was successful in 509/578 patients (88.1%). The main predictors of IOC failure were age, body mass index, male gender and associated acute cholecystitis. Thirty-two patients with suspected common bile duct stone on IOC underwent 38 unnecessary negative postoperative common bile duct investigations (32/509, 6.3%). There was one IOC-related adverse outcome (mild pancreatitis, 1/578, 0.2%).ConclusionsIOC can be successfully and safely performed in the majority of patients undergoing cholecystectomy for acute gallstone-related disease. Although its positive predictive value is suboptimal and results in a number of unnecessary postoperative common bile duct investigations, IOC accurately rules out common bile duct stones in patients with acute gallstone-related conditions.

show abstract

Section: Discussionsupporting

confidence: 54%

Feasibility, benefit and risk of systematic intraoperative cholangiogram in patients undergoing emergency cholecystectomy

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Newly generated model for predicted probability of choledocholithiasis sets limits for (19). Metaanalyses showed that these two diagnostic procedures are quite comparable but EUS has better diagnostic accuracy (20,21). Just one trial comparing EUS and IOC was found in PubMed database and showed better predictive values of IOC (22).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Management Strategies, "Endoscopy First" and "Laparoscopic Cholecystectomy First", for Patients with Gallbladder Stones and Intermediate Risk for Choledocholithiasis: Study Protocol for a Diagnostic Randomized Trial

Aleknaite

Simutis

Stanaitis

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: The optimal approach for patients with gallbladder stones and intermediate risk for choledocholithiasis still remains undetermined. Use of diagnostic endoscopic retrograde cholangiopancreatography should be minimized as it carries considerable risk of post-procedural complications. This study compares two different management strategies: intraoperative cholangiography and endoscopic ultrasound before laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis and intermediate risk for choledocholithiasis. Methods: It is a diagnostic randomized active-controlled single-centre clinical trial enrolling adult patients undergoing laparoscopic cholecystectomy due to symptomatic gallbladder stones with intermediate risk for choledocholithiasis. The risk for choledocholithiasis is calculated using an original prognostic score – Vilnius University Hospital Index. A total of 106 participants will be included and randomized into two groups. Evaluation of bile ducts using endoscopic ultrasound and endoscopic retrograde cholangiography on demand will be performed before laparoscopic cholecystectomy for one arm (“Endoscopy first”). Intraoperative cholangiography during laparoscopic cholecystectomy and postoperative endoscopic retrograde cholangiopancreatography on demand will be administered in another arm (“Cholecystectomy first”). Postoperative follow-up is 6 months. The primary endpoint is the length of hospital stay. Secondary endpoints will include accuracy of the different management strategies, adverse events of interventions, duct clearance and technical success of interventions (intraoperative cholangiography, endoscopic ultrasound, endoscopic retrograde cholangiography), costs of treatment. Discussion: This trial is planned determine which strategy is better approach for a patient with intermediate common bile duct stones risk and to define a simple to calculate and safe algorithm on managing choledocholithiasis. Trial registration: The trial is registered at ClinicalTrials.gov, identification number NCT03658863.

show abstract

“…Latest EASL (The European Association for the Study of the Liver) guidelines also state that patients with intermediate probability should undergo further evaluation with EUS or MRCP but do not define what this intermediate probability is (19). Metaanalyses showed that these two diagnostic procedures are quite comparable but EUS has better diagnostic accuracy (20,21). Just one trial comparing EUS and IOC was found in PubMed database and showed better predictive values of IOC (22).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Two Management Strategies, "Endoscopy First" and "Laparoscopic Cholecystectomy First", for Patients with Gallbladder Stones and Intermediate Risk for Choledocholithiasis: Study Protocol for a Randomized Trial

Aleknaite

Simutis

Stanaitis

et al. 2019

Preprint

View full text Add to dashboard Cite

Background: The optimal approach for patients with gallbladder stones and intermediate risk for choledocholithiasis still remains undetermined. Use of diagnostic endoscopic retrograde cholangiopancreatography should be minimized as it carries considerable risk of post-procedural complications. This study compares two different management strategies: intraoperative cholangiography and endoscopic ultrasound before laparoscopic cholecystectomy for patients with symptomatic cholecystolithiasis and intermediate risk for choledocholithiasis. • Methods: It is a prospective randomized single-centre clinical trial enrolling adult patients undergoing laparoscopic cholecystectomy due to symptomatic gallbladder stones with intermediate risk for choledocholithiasis. The risk for choledocholithiasis is calculated using an original prognostic score – Vilnius University Hospital Index. A total of 106 participants will be included and randomized into two groups. Evaluation of bile ducts using endoscopic ultrasound and endoscopic retrograde cholangiography on demand will be performed before laparoscopic cholecystectomy for one arm (“Endoscopy first”). Intraoperative cholangiography during laparoscopic cholecystectomy and postoperative endoscopic retrograde cholangiopancreatography on demand will be administered in another arm (“Cholecystectomy first”). Postoperative follow-up is 6 months. The primary endpoint is the length of hospital stay. Secondary endpoints will include accuracy of the different management strategies, adverse events of interventions, duct clearance and technical success of interventions (intraoperative cholangiography, endoscopic ultrasound, endoscopic retrograde cholangiography), costs of treatment. • Discussion: This trial is planned determine which strategy is better approach for a patient with intermediate common bile duct stones risk and to define a simple to calculate and safe algorithm on managing choledocholithiasis. • Trial registration: The trial is registered at ClinicalTrials.gov, identification number NCT03658863.

show abstract

Diagnostic accuracy of EUS compared with MRCP in detecting choledocholithiasis: a meta-analysis of diagnostic test accuracy in head-to-head studies

Cited by 120 publications

References 36 publications

Feasibility, benefit and risk of systematic intraoperative cholangiogram in patients undergoing emergency cholecystectomy

Feasibility, benefit and risk of systematic intraoperative cholangiogram in patients undergoing emergency cholecystectomy

Comparison of Two Management Strategies, "Endoscopy First" and "Laparoscopic Cholecystectomy First", for Patients with Gallbladder Stones and Intermediate Risk for Choledocholithiasis: Study Protocol for a Diagnostic Randomized Trial

Comparison of Two Management Strategies, "Endoscopy First" and "Laparoscopic Cholecystectomy First", for Patients with Gallbladder Stones and Intermediate Risk for Choledocholithiasis: Study Protocol for a Randomized Trial

Contact Info

Product

Resources

About