Helical computed tomographic cholangiography versus endosonography for suspected bile duct stones: a prospective blinded study in non-jaundiced patients

Polkowski, Marcin; Pałucki, Jakub; Reguła, Jarosław; Tilszer, A; Butruk, E

doi:10.1136/gut.45.5.744

Cited by 78 publications

(43 citation statements)

References 25 publications

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“…other studies were usually higher: 6.9 mm (2) and 10.5 mm (12) . The association of small stones in a large duct could explain the low sensitivity of ERC.…”

Section: Discussionmentioning

confidence: 63%

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Endoscopic ultrasound versus endoscopic retrograde cholangiography for the diagnosis of choledocholithiasis: the influence of the size of the stone and diameter of the common bile duct

Ney

Maluf‐Filho

Sakai

et al. 2005

Arq. Gastroenterol.

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-Background -Endoscopic retrograde cholangiography is highly accurate in diagnosing choledocholithiasis, but it is the most invasive of the available methods. Endoscopic ultrasonography is a very accurate test for the diagnosis of choledocholithiasis with a risk of complications similar to that of upper gastrointestinal endoscopy. Aim -To compare the accuracy of endoscopic ultrassonography and endoscopic retrograde cholangiography in the diagnosis of common bile duct stones before laparoscopic cholecystectomy and to analyze endoscopic ultrasound results according to stone size and common bile duct diameter. Patients and Methods -Two hundred and fifteen patients with symptomatic gallstones were admitted for laparoscopic cholecystectomy. Sixty-eight of them (31.7%) had a dilated common bile duct and/or hepatic biochemical parameter abnormalities. They were submitted to endoscopic ultrassonography and endoscopic retrograde cholangiography. Sphincterotomy and sweeping of the common bile duct were performed if endoscopic ultrassonography or endoscopic retrograde cholangiography were considered positive for choledocholithiasis. After sphincterotomy and common bile duct clearance the largest stone was retrieved for measurement. Endoscopic or surgical explorations of the common bile duct were considered the gold-standard methods for the diagnosis of choledocholithiasis. Results -All 68 patients were submitted to laparoscopic cholecystectomy with intraoperative cholangiography with confirmation of the presence of gallstones. Endoscopic ultrassonography was a more sensitivity test than endoscopic retrograde cholangiography (97% vs. 67%) for the detection of choledocholithiasis. When stones >4.0 mm were analyzed, endoscopic ultrassonography and endoscopic retrograde cholangiography presented similar results (96% vs. 90%). Neither the size of the stone nor the common bile duct diameter had influence on endoscopic ultrasonographic performance. Conclusions -For a group of patients with an intermediate or moderate risk with respect to the likelihood of having common bile duct stones, endoscopic ultrassonography is a better test for the diagnosis of choledocholithiasis when compared to endoscopic retrograde cholangiography mainly for small-sized calculi. HEADINGS -Endosonography. Cholangiopancreatography, endoscopic retrograde. Choledochotilhiasis, diagnosis. Common bile duct.

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“…other studies were usually higher: 6.9 mm (2) and 10.5 mm (12) . The association of small stones in a large duct could explain the low sensitivity of ERC.…”

Section: Discussionmentioning

confidence: 63%

“…There are nine studies which include a total of 601 patients comparing EUS and ERC to diagnose CBD stones (1,2,3,6,10,12,13,14,15) . In eight of these studies, endoscopic exploration of the CBD was used as the reference standard.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound versus endoscopic retrograde cholangiography for the diagnosis of choledocholithiasis: the influence of the size of the stone and diameter of the common bile duct

Ney

Maluf‐Filho

Sakai

et al. 2005

Arq. Gastroenterol.

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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

1,631

980

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“…A 3D real-time ultrasonography technique is now being developed and has been applied to the measurement of gallbladder shape and volume [53] . The 3D spiral/helical computed tomography (CT) has also been involved in diagnosis of cholecystitis, since it not only shows the 3D images of the gallbladder but also of the whole biliary tract [54][55][56][57][58][59][60] . These techniques may in the future facilitate the development of specific models for measuring flow resistance.…”

Section: The Pressure-volume Relationmentioning

confidence: 99%

On the mechanical behavior of the human biliary system

Luo

Li²,

Bird³

et al. 2007

WJG

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This paper reviews the progress made in understanding the mechanical behaviour of the biliary system. Gallstones and diseases of the biliary tract affect more than 10% of the adult population. The complications of gallstones, i.e. acute pancreatitis and obstructive jandice, can be lethal, and patients with acalculous gallbladder pain often pose diagnostic difficulties and undergo repeated ultrasound scans and oral cholecystograms. Moreover, surgery to remove the gallbladder in these patients, in an attempt to relieve the symptoms, gives variable results. Extensive research has been carried out to understand the physiological and pathological functions of the biliary system, but the mechanism of the pathogenesis of gallstones and pain production still remain poorly understood. It is believed that the mechanical factors play an essential role in the mechanisms of the gallstone formation and biliary diseases. However, despite the extensive literature in clinical studies, only limited work has been carried out to study the biliary system from the mechanical point of view. In this paper, we discuss the state of art knowledge of the fluid dynamics of bile flow in the biliary tract, the solid mechanics of the gallbladder and bile ducts, recent mathematical and numerical modelling of the system, and finally the future challenges in the area.

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Helical computed tomographic cholangiography versus endosonography for suspected bile duct stones: a prospective blinded study in non-jaundiced patients

Cited by 78 publications

References 25 publications

Endoscopic ultrasound versus endoscopic retrograde cholangiography for the diagnosis of choledocholithiasis: the influence of the size of the stone and diameter of the common bile duct

Endoscopic ultrasound versus endoscopic retrograde cholangiography for the diagnosis of choledocholithiasis: the influence of the size of the stone and diameter of the common bile duct

Practice Guidelines in Acute Pancreatitis

On the mechanical behavior of the human biliary system

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