Endosonography with linear array instead of endoscopic retrograde cholangiography as the diagnostic tool in patients with moderate suspicion of common bile duct stones

Kohut, Maciej; Nowak, Andrzej; Nowakowska-Duława, Ewa; Marek, Tomasz; Kaczor, R

doi:10.3748/wjg.v9.i3.612

Cited by 30 publications

(13 citation statements)

References 21 publications

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“…Furthermore, it has been previously reported [17] that a considerable portion of patients with intermediate risk of CBD stones (as in our current study consisting of a group of patients with no direct evidence of CBD stone found by transabdominal ultrasound/CT scan) have no evidence of stones by linear EUS, thus, avoiding unnecessary invasive evaluation of the bile duct with ERCP.…”

Section: Discussionmentioning

confidence: 54%

Linear echoendoscope-guided ERCP for the diagnosis of occult common bile duct stones

et al. 2013

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BackgroundLess than 67% of patients with intermediate risk for common bile duct (CBD) stones require therapeutic intervention. It is important to have an accurate, safe, and reliable method for the definitive diagnosis of CBD stones before initiating therapeutic endoscopic retrograde cholangiopancreatography (ERCP). Few publications detail the diagnostic efficacy of linear echoendoscopy (EUS) for CBD stones.Methods30 patients with biliary colic, pancreatitis, unexplained derangement of liver function tests, and/or dilated CBD without an identifiable cause were enrolled in the study. When a CBD stone was disclosed by linear EUS, ERCP with stone extraction was performed. Patients who failed ERCP were referred for surgical intervention. If no stone was found by EUS, ERCP would not be performed and patients were followed-up for possible biliary symptoms for up to three months.ResultsThe major reason for enrollment was acute pancreatitis. The mean predicted risk for CBD stones was 47% (28–61). Of the 12 patients who were positive for CBD stones by EUS, nine had successful ERCP, one failed ERCP (later treated successfully by surgical intervention) and two were false-positive cases. No procedure-related adverse events were noted. For those 18 patients without evidence of CBD stones by EUS, no false-negative case was noted during the three-month follow-up period. Linear EUS had sensitivity, specificity, positive and negative predicted values for the detection of CBD stones of 1, 0.9, 0.8 and 1, respectively.ConclusionLinear EUS is safe and efficacious for the diagnosis of occult CBD stones in patients with intermediate risk for the disease.

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Section: Discussionmentioning

confidence: 54%

Linear echoendoscope-guided ERCP for the diagnosis of occult common bile duct stones

et al. 2013

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“…Gallstones can be documented within the common bile duct with accuracy similar to ERCP by EUS (39,205,(207)(208)(209)(210)(211)(212)(213)(214)(215)(216)(217)(218)(219)(220)(221)(222)(223)(224)(225)(226), with somewhat lower accuracy by MRCP (227)(228)(229)(230)(231)(232)(233), and by intraoperative cholangiography at the time of laparoscopic cholecystectomy (234)(235)(236)(237). Identification of a biliary etiology of acute pancreatitis is important because recurrent episodes will occur in one-third to two-thirds of these patients in follow-up periods of as short as 3 months unless gallstones are eliminated (238,239).…”

Section: Treatment Guideline Vii: Role Of Ercp and Biliary Sphincteromentioning

confidence: 99%

Practice Guidelines in Acute Pancreatitis

Banks

Freeman

2006

Am J Gastroenterology

1,662

980

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“…Kohut et al did not use ERCP either, but their clinical follow-up for negative CBDS on linear EUS was of longer duration. 10 The limitation of our study is the shorter follow-up period in some cases of negative CBDS, although the median follow-up duration was 9 months.…”

Section: Discussionmentioning

confidence: 93%

Linear endoscopic ultrasound for clinically suspected bile duct stones

Lin¹,

Huang²

2012

Journal of the Chinese Medical Association

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Endosonography with linear array instead of endoscopic retrograde cholangiography as the diagnostic tool in patients with moderate suspicion of common bile duct stones

Abstract: Vast majority of patients with moderate suspicion of CBDS and no stones on EUS with linear array can avoid invasive evaluation of biliary tree with ERC.

Cited by 30 publications

References 21 publications

Linear echoendoscope-guided ERCP for the diagnosis of occult common bile duct stones

Linear echoendoscope-guided ERCP for the diagnosis of occult common bile duct stones

Practice Guidelines in Acute Pancreatitis

Linear endoscopic ultrasound for clinically suspected bile duct stones

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