The role of endoscopic ultrasound in evaluating patients with bile duct dilation of unclear etiology

Phan, Jennifer; Ge, Phillip S.; Kardashian, Ani; Kim, Stephen; Sedarat, Alireza; Watson, Rabindra R.; Muthusamy, V. Raman

doi:10.1111/1751-2980.13046

Cited by 3 publications

(4 citation statements)

References 23 publications

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“…Also, many previous studies reported close results (6,7,10) . In contrast Phan et al (8) reported that the majority of patients (63.5%) were men, and at diagnosis, the average age was 64.6 ± 14.7 years. As common there are numerous factors that can result in bile duct dilatation, when one of these factors is present, patients may experience biliary pain, jaundice, or changes in their liver's chemistry (11) .…”

Section: Discussionmentioning

confidence: 84%

“…The biliary anatomy can be accurately diagnosed with EUS, and there is also the chance to obtain a sample for a histological conclusion. Moreover, it permits evaluation of invasion and local staging of any malignant lesion (7,8) .…”

Section: Discussionmentioning

confidence: 99%

“…While, in terms of prior imaging, Oppong et al (12) reported that 26 (36%) patients had either a CT scan or MRI and 29 (40%) had both. Also, Phan et al (8) reported that prior to EUS, an average of 1.8 ± 1.0 imaging investigations were carried out on each patient.…”

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: 84%

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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“…In a recent paper by Phan et al, a diagnostic yield of 69.4% was achieved for BDD. Malignancy was confirmed in 8.1% of patients with BDD and normal liver function tests warranting EUS examination in these cases [138].…”

Section: Staging Of Pancreatobiliary Malignanciesmentioning

confidence: 89%

Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?

et al. 2021

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As the burden of liver disease in the general populace steadily increases, so does the need for both advanced diagnostic and treatment options. Endoscopic ultrasound is a reliable diagnostic and therapeutic method that has an established role, foremost in pancreatobiliary pathology. This paper aims to summarize the growing role of endoscopic ultrasound in hepatology based on the search of the current literature. A number of applications of endoscopic ultrasound are reviewed, including both noninvasive methods and tissue acquisition in focal and diffuse liver disease, portal hypertension measurement, detection and management of gastric and esophageal varices, treatment of focal liver lesions and staging of pancreatobiliary malignancies, treatment of cystic and solid liver lesions, as well as liver abscess drainage. Both hepatologists and endoscopists should be aware of the evolving role of endoscopic ultrasound in liver disease. The inherent invasive nature of endoscopic examination limits its use to a targeted population identified using noninvasive methods. Endoscopic ultrasound is one the most versatile methods in gastroenterology, allowing immediate access with detection, sampling, and treatment of digestive tract pathology. Further expansion of its use in hepatology is immanent.

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Different Etiologies of Dilated Pancreatic Duct Based on Endoscopic Ultrasonography Findings

Sobhrakhshankhah,

Zamani,

Ajdarkosh

et al. 2024

Middle East J Dig Dis

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Background: Pancreatic duct (PD) dilation could be presented in both benign and malignant diseases. Endoscopic ultrasonography (EUS) is a sensitive modality that provides both structural assessment and tissue sampling. This study aims to explore the importance of PD dilation as a potential indicator related to various pancreatobiliary pathologies identified via EUS. Methods: Among 3109 subjects who underwent EUS, 599 had evidence of dilated PD and met the inclusion criteria of this retrospective study. Also, the patients underwent EUS fine needle aspiration (EUS-FNA) to evaluate the etiology when required. All data were extracted from patients’ medical records to perform statistical analysis. Results: The study sample revealed 64% being male with a median age was 65-years. Pancreatic adenocarcinoma was the most common etiology diagnosed in 236 patients (39.4%), followed by sphincter of Oddi dysfunction (SOD) in 13% of subjects. Ampullary carcinoma, common bile duct stone, and cholangiocarcinoma were found at 9.5%, 8.8%, and 6.8%, respectively. Abdominal pain was the most common symptom seen in 440 (73.4%) patients. Opium consumption was reported in 170 (28.4%) subjects. Opium consumption was significantly more prevalent in patients with SOD (P<0.05). Conclusion: We suggest that PD dilation could be associated with a wide range of pancreaticobiliary pathologies, especially pancreatic neoplasms. In this regard, PD dilation should be considered as a crucial indicator of pancreatic neoplasm despite it may be associated with no clear etiologies.

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The role of endoscopic ultrasound in evaluating patients with bile duct dilation of unclear etiology

Cited by 3 publications

References 23 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

Role of Endoscopic Ultrasound in Liver Disease: Where Do We Stand?

Different Etiologies of Dilated Pancreatic Duct Based on Endoscopic Ultrasonography Findings

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