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AIM:The aim is to determine the role of endoscopic ultrasonography in assessment of etiological diagnosis of bile ducts dilation when conventional imaging is inconclusive. BACKGROUND: Endoscopic ultrasonography (EUS) is an effective and primordial procedure in exploration of abnormalities of biliopancreatic junction. However, its results depend of the operator expertise, and its availability is currently insufficient in our regions. METHODS: This is a retrospective descriptive study conducted from January 2008 to May 2019, including 42 patients with intraand/or extra-hepatic bile duct dilatation without visible obstacle on imaging. TODANI classification was considered for common bile duct (CBD) cystic dilations. Statistical analysis was performed by SPSS software version 24.0. RESULTS:We enrolled 42 patients responding to inclusion criteria in the study, which represented 10.18% of all indications of EUS. The mean age of our patients was 59.05 ± 13.11 years, with a female predominance. Endoscopic findings showed a normal papilla in 92.9%. EUS showed a dilated CBD in 66.8% of cases, she has allowed to make the diagnosis of a cystic dilation of CBD in 52.4%, predominated by type Ia and Ib in 45.2% and 4.8% respectively, of ampulloma in 4.8% (n = 2), papillomatosis of the bile ducts in 2.4% (n = 1), one case of pancreatic head tumor (2,4%), and choledocholithiasis in 4.8% (n = 2). By against EUS showed no expansion in 33.3% (n = 14). CONCLUSION: Our study confirms the prominent place of EUS in etiological profile of bile ducts dilatations when imaging is inconclusive.

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