Diagnosis of choledocholithiasis by endoscopic ultrasonography

Amouyal, Paul; Amouyal, Gilles; Lévy, Philippe; Tuzet, Sylvie; Palazzo, Laurent; Vilgrain, Valérie; Gayet, Brice; Belghiti, Jacques; Fékété, F; Bernadès, P

doi:10.1016/0016-5085(94)90768-4

Cited by 230 publications

(93 citation statements)

References 18 publications

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“…EUS has been shown to have excellent sensitivity (84%-100%) and specificity (90%-100%) in a number of prospective trials (11)(12)(13)(20)(21)(22)(23). In our study, EUS demonstrated 100% sensitivity and 84% specificity, with a 100% negative predictive value.…”

Section: Discussionsupporting

confidence: 52%

“…The risk of pancreatitis following EUS, however, is essentially zero. A zero-complication rate has been noted in multiple other series of EUS (11)(12)(13)(20)(21)(22)(23). This is in contrast to the well-known complications of ERCP.…”

Section: Discussionmentioning

confidence: 91%

“…ERCP carries an associated 0.1% to 1.3% mortality rate and 5% to 19% morbidity rate (1-3), including a reported 1.8% to 6.7% incidence of pancreatitis (1,(3)(4)(5). Furthermore, of all ERCPs done for suspected CDL, 27% to 66% result in a normal examination with no stones identified (2,(6)(7)(8)(9)(10)(11)(12)(13).…”

mentioning

confidence: 99%

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Usefulness of Endoscopic Ultrasound in Patients at High Risk of Choledocholithiasis

Dittrick

Lamont²,

Kuhn³

et al. 2005

Baylor University Medical Center Proceedings

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Background: Endoscopic retrograde cholangiopancreatography (ERCP) has been considered the nonsurgical gold standard for the diagnosis and treatment of choledocholithiasis (CDL). Complications include a 0.1% to 1.3% mortality rate and a 5% to 19% morbidity rate, including a reported 1.8% to 6.7% incidence of postprocedure pancreatitis. Twenty-seven percent to 67% of ERCPs done for suspected choledocholithiasis ultimately have negative results. Endoscopic ultrasound (EUS) has been proposed as an alternate means of diagnosing choledocholithiasis that may eliminate the need for ERCP and its associated morbidities in certain patients. Methods: Retrospective chart review identified 30 patients who underwent EUS with or without ERCP for suspected choledocholithiasis. Reports of all procedures performed were obtained and data were collected on all biliary abnormalities identified on both EUS and ERCP. Results: Pancreaticobiliary abnormalities were identified in 27 of 30 pa-

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 91%

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Usefulness of Endoscopic Ultrasound in Patients at High Risk of Choledocholithiasis

Dittrick

Lamont²,

Kuhn³

et al. 2005

Baylor University Medical Center Proceedings

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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

1,677

980

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“…On the other hand, a small stone may be missed in the very dilated common bile duct. According to the available literature, the sensitivity and specificity of ERCP in detecting choledocholithiasis are 79-93 % and 92-100%, respectively 3,[17][18][19][20][21] . Although EUS is also investigator-dependent, it is unparalleled for the intimate relation between the ultrasound probe and the investigated area.…”

Section: Introductionmentioning

confidence: 99%

Endosonography Versus Endoscopic Retrograde Cholangiopancreatography in Diagnosing Extrahepatic Biliary Obstruction

Angelo¹,

Procházka²,

Holinka³

et al. 2011

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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Objective. Endosonography (EUS) performed prior to endoscopic retrograde cholangiopancreatography (ERCP) or surgery in patients with a low to moderate probability of choledocholithiasis can reduce morbidity, mortality and costs.Aims. This study aimed at evaluating the sensitivity and specificity of EUS and transabdominal ultrasonography (TUS) compared to ERCP in a cohort of 100 patients diagnosed with extrahepatic biliary obstruction.Methods. There were four working groups. The first group processed the initial data including history, physical examination and assessment of laboratory markers of cholestasis. The second group examined TUS. The third group examined the pancreas and biliary tree using EUS, always prior to ERCP. The fourth working group carried out ERCP.Results. The sensitivity and accuracy of EUS in the diagnosis of common bile duct dilatation were 84% and 83%, respectively, i.e. significantly higher (p=0.0001) than TUS (46% and 66%, respectively). The specificities of methods (82%, 91%) were not significantly different (p=0.218). The sensitivity and accuracy of EUS in the diagnosis of pathological content of the common bile duct were 88% and 92%, respectively, i.e. significantly higher (p<0.0001) than TUS (33% and 64%). The specificities of the methods (96%, 94%) were not significantly different (p=0.641).The incidence of choledocholithiasis in the high-risk group was significantly higher than in the moderate-risk group (p=0.012).Conclusion. Radial EUS is a method with high sensitivity, specificity, positive and negative predictive values. It should therefore be preferred to ERCP in patients with low or moderate risk of choledocholithiasis.

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Diagnosis of choledocholithiasis by endoscopic ultrasonography

Cited by 230 publications

References 18 publications

Usefulness of Endoscopic Ultrasound in Patients at High Risk of Choledocholithiasis

Usefulness of Endoscopic Ultrasound in Patients at High Risk of Choledocholithiasis

Practice Guidelines in Acute Pancreatitis

Endosonography Versus Endoscopic Retrograde Cholangiopancreatography in Diagnosing Extrahepatic Biliary Obstruction

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