Diagnostic accuracy of ultrasonography compared with magnetic resonance cholangiopancreatography in the detection of choledocholithiasis

Samara, Osama; Azzam, Muayad I.; Alshrouf, Mohammad Ali; Khanfar, Asim; Mohialdeen, Rand Rafid; Barham, Ola Fawwaz; Barham, Mohammad Fawwaz; AlRyalat, Saif Aldeen

doi:10.1002/jcu.23136

Cited by 6 publications

(3 citation statements)

References 26 publications

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“…Transabdominal ultrasound is the most commonly used imaging test. When the dilatation of the common bile duct exceeds 6 mm, there is a high prevalence of choledocholithiasis [ 11 ]. Magnetic resonance cholangiopancreatography (MRCP) is highly sensitive and specific in detecting choledocholithiasis.…”

Section: Introductionmentioning

confidence: 99%

The Laparoscopic Cholecystectomy and Common Bile Duct Exploration: A Single-Step Treatment of Pediatric Cholelithiasis and Choledocholithiasis

et al. 2022

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Background: In recent years, complicated biliary tract diseases are increasingly diagnosed in children. Laparoscopic exploration of the common bile duct (LCBDE) followed by laparoscopic cholecystectomy has gained popularity in children. The aim of this study was to investigate the outcomes of LCBDE in children and compare them with the treatment outcomes of previously used endoscopic retrograde cholangiopancreatography (ERCP). Methods: From January 2000 to January 2022, a total of 84 children (78.5% female) underwent laparoscopic cholecystectomy with a median follow-up of 11.4 (IQR 8, 14) years. Of these, 6 children underwent laparoscopic cholecystectomy (LC) + ERCP and 14 children underwent LCBDE for choledochiothiasis. The primary end point of the study was the success of treatment in terms of the incidence of complications, recurrence rate, and rate of reoperation. Secondary endpoints were stone characteristics, presenting symptoms, duration of surgery, and length of hospital stay. Results: The majority of patients were female in both groups (83.5% vs. 85.7%), mostly overweight with a median BMI of 27.9 kg/m2 and 27.4 kg/m2, respectively. Obstructive jaundice, colicky pain, acute pancreatitis, and obstruction of the papilla were the most common symptoms in both groups. The majority of patients (68%) had one stone, whereas two or more stones were found in 32% of patients. The median diameter of the common bile duct was 9 mm in both groups. The procedure was successfully completed in all patients in the ERCP group. In the group of patients treated with LCBDE, endoscopic extraction of the stone with a Dormia basket was successfully performed in ten patients (71.4%), while in the remaining four patients (28.6%) the stones were fragmented with a laser because extraction with the Dormia basket was not possible. The median operative time was 79 min in the LCBDE group (IQR 68, 98), while it was slightly longer in the ERCP group, 85 min (IQR 74, 105) (p = 0.125). The length of hospital stay was significantly shorter in the LCBDE group (2 vs. 4 days, p = 0.011). No complications occurred in the LCBDE group, while two (40%) complications occurred in the ERCP group: pancreatitis and cholangitis (p = 0.078). During the follow-up period, no conversions, papillotomies, or recurrences were recorded in either group. Conclusions: Exploration of the common bile duct and removal of stones by LCBDE is safe and feasible in pediatric patients for the treatment of choledocholithiasis. Through this procedure, choledocholithiasis and cholelithiasis can be treated in a single procedure without papillotomy or fluoroscopy. Compared with LC + ERCP, LCBDE is associated with a shorter hospital stay. The incidence of complications was rather low but not statistically significant.

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Section: Introductionmentioning

confidence: 99%

The Laparoscopic Cholecystectomy and Common Bile Duct Exploration: A Single-Step Treatment of Pediatric Cholelithiasis and Choledocholithiasis

et al. 2022

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“…US is usually recommended as the first line work-up in pancreatobiliary abnormality due to its low cost, noninvasiveness, and radiation-free. However, the relatively low accuracy limits its diagnostic value in EBD dilation [6]. Although it is an important imaging technique commonly used to examine abdominal disease, CT also shows relatively low accuracy in detecting biliary disorders.…”

Section: Introductionmentioning

confidence: 99%

Role of endoscopic ultrasound in the evaluation of unexplained extrahepatic bile duct dilatation

Chen

Wang

Dai

et al. 2022

European Journal of Gastroenterology &Amp; Hepatology

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Objective This study was performed to assess the diagnostic performance of endoscopic ultrasonography (EUS) in patients with extrahepatic bile duct (EBD) dilatation and develop a novel model incorporating EUS-based signature with clinical parameters for distinguishing the malignant dilation of EBD. Methods The EUS data and clinical parameters of the patients were collected and analyzed retrospectively. First, we evaluated the diagnostic performance of EUS in detecting the cause of EBD dilatation. Then, we performed univariate and multivariate binary logistic regression analyses based on clinical and EUS features. Finally, a nomogram was established to aid in distinguishing between malignant dilation and noncalculous benign dilatation of EBD in patients.Results A total of 184 patients were enrolled. For the diagnosis of malignant dilation, EUS achieved an accuracy of 90.76%, sensitivity of 85.96%, and specificity of 92.91%. For the diagnosis of calculous dilation, EUS achieved an accuracy of 100%, sensitivity of 100%, and specificity of 100%. For the diagnosis of noncalculous benign dilatation, EUS achieved an accuracy of 90.76%, sensitivity of 90.90%, and specificity of 90.58%. Multivariable logistic regression analyses indicated that abnormal liver function test, elevated tumor markers, and EUS findings were the well-diagnostic factors of malignant EBD dilation. The nomogram established by these factors showed good calibration and discrimination. Conclusion EUS is a useful examinational modality in the work-up of EBD dilatation. In combination with abnormal liver function test and elevated tumor markers, EUS may provide additional information for the detection of malignant dilation of EBD and should be further investigated.

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“…In this very interesting study, 1 the authors compared the diagnostic accuracy of ultrasonography (US) with magnetic resonance cholangiopancreatography (MRCP) for the evaluation of choledocholithiasis. The authors retrospectively selected 243 patients suspected for choledocholithiasis who underwent both US and MRCP within 1 month, then they compared common bile duct measurements, false positive and false negative percentages in common bile duct stone detection.…”

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confidence: 99%

Role of magnetic resonance cholangiopancreatography in choledocholithiasis

Bellini

Carbone

2022

J of Clinical Ultrasound

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In this very interesting study, 1 the authors compared the diagnostic accuracy of ultrasonography (US) with magnetic resonance cholangiopancreatography (MRCP) for the evaluation of choledocholithiasis. The authors retrospectively selected 243 patients suspected for choledocholithiasis who underwent both US and MRCP within 1 month, then they compared common bile duct measurements, false positive and false negative percentages in common bile duct stone detection. The authors concluded that US is ideal as the first step in the diagnostic algorithm for choledocholithiasis. Diagnostic accuracy was high, in line with previously published paper (AUC = 0.727; 95% CI, 0.603-0.852).However, due to the high percentage of false negatives (16%), if patients have elevated liver enzymes or a high risk of CBD stones, MRCP is recommended. This paper underlines the role of US as first

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Diagnostic accuracy of ultrasonography compared with magnetic resonance cholangiopancreatography in the detection of choledocholithiasis

Cited by 6 publications

References 26 publications

The Laparoscopic Cholecystectomy and Common Bile Duct Exploration: A Single-Step Treatment of Pediatric Cholelithiasis and Choledocholithiasis

The Laparoscopic Cholecystectomy and Common Bile Duct Exploration: A Single-Step Treatment of Pediatric Cholelithiasis and Choledocholithiasis

Role of endoscopic ultrasound in the evaluation of unexplained extrahepatic bile duct dilatation

Role of magnetic resonance cholangiopancreatography in choledocholithiasis

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