Combined use of endosonography and endoscopic retrograde cholangiopancreatography in the same session

Ünsal, Belkıs; Alper, Emrah; Baydar, Behlül; Aslan, Fatih; Akpınar, Zehra; Buyraç, Zafer; Aksöz, Mehmet Kadir

doi:10.4318/tjg.2011.0157

Cited by 3 publications

(4 citation statements)

References 16 publications

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“…18 EUS on the contrary can pick up diminutive stones and can be used for histological diagnosis. 19 A cost-analysis study from Thailand concluded that EUS preceding ERCP procedure was more costeffective as EUS could successfully rule out CBD stones, eliminating the need for invasive ERCP. 7 The same study also reported a 60%-70% less cost of EUS versus diagnostic and/or therapeutic ERCP in lieu of lesser post-ERCP complications, hospital stay, rehabilitation and work days lost.…”

Section: Discussionmentioning

confidence: 99%

Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool

Khan¹,

Alam²,

Khan³

et al. 2023

Pak J Med Sci

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Objective: To evaluate the diagnostic accuracy of different imaging modalities in patients with partial biliary obstruction with no obvious aetiology on initial imaging. Methods: This is a prospective single-centre cohort study carried out at Pak Emirates Military Hospital, Rawalpindi from June 2019 to June 2021 with non-probability consecutive sampling. Patients with ages 16 to 75 years, presenting with partial biliary obstruction and undetermined aetiology on initial imaging (TUS and MRCP) were enrolled. EUS was performed for each of these patients and the case was regarded as “true positive” or “true negative” if the findings of imaging modality correlated to those of ERCP. ROC curve, sensitivity, specificity, PPV, NPV and AUC (with 95% confidence interval) were drawn for all the diagnostic tools using SPSS V. 21. Results: A total of 65 patients were enrolled over a period of two years with male to female ratio of 1.4:1. Forty-four patients had an intermediate risk of choledocholithiasis upon preliminary evaluation whereas, 48(74%) of the participants had CBD calculi or sludge confirmed upon subsequent ERCP. Trans-abdominal ultrasound showed the lowest sensitivity (29.2%), specificity (85%), NPV 12% and PPV 93% for diagnosing CBD calculi. This was followed by MRCP with a sensitivity of 37.5%, specificity of 100%, NPV of 36.2% and PPV of 100%. EUS showed the maximum diagnostic accuracy with AUC of 1.0 and a 100% sensitivity and specificity when compared with ERCP as gold standard. Conclusion: EUS is superior to MRCP in terms of diagnostic accuracy as minimally invasive diagnostic tool and EUS superiority is particularly relevant in patients with intermediate risk of choledocholithiasis. doi: https://doi.org/10.12669/pjms.39.5.7280 How to cite this: Khan RSA, Alam L, Khan ZA, Khan UA. Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7280 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool

Khan¹,

Alam²,

Khan³

et al. 2023

Pak J Med Sci

View full text Add to dashboard Cite

show abstract

“…[ 6 ] Because in most studies, EUS has high sensitivity and specificity for identifying stones <3 mm, but it is hard for MRCP. [ 7 ] Moreover, EUS and MRCP should be compared with regard to the different sizes and types of stones.…”

Section: Comparing Endoscopic Ultrasonography and Magnetic Resonance mentioning

confidence: 99%

“…However, even although EUS is a more invasive method than MRCP, it can be performed before ERCP during the same endoscopy session, and can reduce both the risk to the patient of a second anesthesia and the amount of labor involved. [ 7 ]…”

Section: Comparing Endoscopic Ultrasonography and Magnetic Resonance mentioning

confidence: 99%

Endoscopic ultrasonography versus magnetic resonance cholangiopancreatography for suspected choledocholithiasis: Comments from the radiologists′

Pan

Guo

2016

Endosc Ultrasound

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“…Despite its overall high accuracy, the role of EUS in the diagnosis of common bile duct stones has not been firmly established because EUS is relatively more invasive than MRCP and does not permit therapeutic interventions. However, although EUS is a more invasive method than MRCP, it can be performed before ERCP during the same endoscopy session by the same endoscopist [ 11 ].…”

mentioning

confidence: 99%

Optimal Evaluation of Suspected Choledocholithiasis: Does This Patient Really Have Choledocholithiasis?

Lee

2017

Clin Endosc

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Combined use of endosonography and endoscopic retrograde cholangiopancreatography in the same session

Cited by 3 publications

References 16 publications

Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool

Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool

Endoscopic ultrasonography versus magnetic resonance cholangiopancreatography for suspected choledocholithiasis: Comments from the radiologists′

Optimal Evaluation of Suspected Choledocholithiasis: Does This Patient Really Have Choledocholithiasis?

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