Linear EUS for bile duct stones

Lachter, Jesse; Rubin, Amir; Shiller, Moshe; Lavy, Alexandra; Yasin, Kamel; Suissa, Alain; Reshef, Ron

doi:10.1016/s0016-5107(00)70387-7

Cited by 49 publications

(31 citation statements)

References 27 publications

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“…Likewise, in comparison with data from investigating crystals in bile using various techniques reported in literature (ERCP), results from EUS were at least similar, without inconveniences of the ERCP method, and were safer presenting notably greater sensitivity 22,41 . Nevertheless, it must be stressed that, to obtain satisfactory conclusions regarding the two techniques, comparative studies with a rigorous methodology are required.…”

Section: Discussionmentioning

confidence: 52%

“…These estimates, with their respective confidence intervals, are questionable and imprecise, considering that in other studies, the specificity ranged from 76% to 86% 39,41 . Perhaps these results occurred because of the small sample of individuals without the disease and the great possibility that the patients examined here would have gallbladder etiology as the cause of their episodes of acute pancreatitis.…”

Section: Discussionmentioning

confidence: 86%

“…Previous studies using EUS to diagnose microlithiasis found sensitivity rates of 95% to 97% 39,41,43 , with a positive predictive value of 100% 43 .…”

Section: Discussionmentioning

confidence: 96%

“…It is also more advantageous than bile collection, because it does not use cholecystokinetic agents to obtain bile, which could, at least hypothetically, cause recurrence or worsening of the pancreatitis 40 . It is also less invasive than ERCP 41 and does not worsen the condition of acute pancreatitis 42 .…”

Section: Discussionmentioning

confidence: 99%

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Microlithiasis of the gallbladder: role of endoscopic ultrasonography in patients with idiopathic acute pancreatitis

Ardengh¹,

Malheiros²,

Rahal³

et al. 2010

Rev. Assoc. Med. Bras.

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SummaryObjectives. Causes may be found in most cases of acute pancreatitis, however no etiology is found by clinical, biological and imaging investigations in 30% of these cases. Our objective was to evaluate results from endoscopic ultrasonography (EUS) for diagnosis of gallbladder microlithiasis in patients with unexplained (idiopathic) acute pancreatitis. MethOds. Thirty-six consecutive non-alcoholic patients with diagnoses of acute pancreatitis were studied over a five-year period. None of them showed signs of gallstones on transabdominal ultrasound or tomography. We performed EUS within one week of diagnosing acute pancreatitis. Diagnosis of gallbladder microlithiasis on EUS was based upon findings of hyperechoic signals of 0.5-3.0 mm, with or without acoustic shadowing. All patients (36 cases) underwent cholecystectomy, in accordance with indication from the attending physician or based upon EUS diagnosis. Results. Twenty-seven patients (75%) had microlithiasis confirmed by histology and nine did not (25%). EUS findings were positive in twenty-five. Two patients had acute cholecystitis diagnosed at EUS that was confirmed by surgical and histological findings. In two patients, EUS showed cholesterolosis and pathological analysis disclosed stones not detected by EUS. EUS diagnosed microlithiasis in four cases not confirmed by surgical treatment. In our study, sensitivity, specificity and positive and negative predictive values to identify gallbladder microlithiasis (with 95% confidence interval) were 92.6% (74.2-98.7%), 55.6% (22.7-84.7%), 86.2% (67.4-95.5%) and 71.4% (30.3-94.9%), respectively. Overall EUS accuracy was 83.2%. cOnclusiOns. EUS is a very reliable procedure to diagnose gallbladder microlithiasis and should be used for the management of patients with unexplained acute pancreatitis. This procedure should be part of advanced endoscopic evaluation.

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Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 86%

“…Previous studies using EUS to diagnose microlithiasis found sensitivity rates of 95% to 97% 39,41,43 , with a positive predictive value of 100% 43 .…”

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

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Microlithiasis of the gallbladder: role of endoscopic ultrasonography in patients with idiopathic acute pancreatitis

Ardengh¹,

Malheiros²,

Rahal³

et al. 2010

Rev. Assoc. Med. Bras.

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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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Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones

Giljača

Gurusamy

Takwoingi

et al. 2015

Cochrane Database of Systematic Reviews

139

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Both EUS and MRCP have high diagnostic accuracy for detection of common bile duct stones. People with positive EUS or MRCP should undergo endoscopic or surgical extraction of common bile duct stones and those with negative EUS or MRCP do not need further invasive tests. However, if the symptoms persist, further investigations will be indicated. The two tests are similar in terms of diagnostic accuracy and the choice of which test to use will be informed by availability and contra-indications to each test. However, it should be noted that the results are based on studies of poor methodological quality and so the results should be interpreted with caution. Further studies that are of high methodological quality are necessary to determine the diagnostic accuracy of EUS and MRCP for the diagnosis of common bile duct stones.

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Linear EUS for bile duct stones

Cited by 49 publications

References 27 publications

Microlithiasis of the gallbladder: role of endoscopic ultrasonography in patients with idiopathic acute pancreatitis

Microlithiasis of the gallbladder: role of endoscopic ultrasonography in patients with idiopathic acute pancreatitis

Endosonography Versus Endoscopic Retrograde Cholangiopancreatography in Diagnosing Extrahepatic Biliary Obstruction

Endoscopic ultrasound versus magnetic resonance cholangiopancreatography for common bile duct stones

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