Routine endoscopic ultrasound in moderate and indeterminate risk patients of suspected choledocholithiasis to avoid unwarranted ERCP: A prospective randomized blinded study

Abstract

In patients with moderate or indeterminate risk for choledocholithiasis, prior EUS done for confirmation of choledocholithiasis avoids unnecessary ERCP in almost half of the cases.

Demystifying endoscopic retrograde cholangiopancreatography (ERCP) during pregnancy

“…These results support the studies of single session EUS-ERCP in non-pregnant patients, demonstrating that ERCP can be safely avoided in a significant number of patients (44-75%, depending on the risk stratification for suspected choledocholithiasis of the patients) [28,29].…”

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

“…Some recent studies have shown that performing EUS or MRCP first for patients at low-to-moderate risk of choledocholithiasis can prevent unnecessary ERCP. [ 13 ] Studies performed in the coming years should clarify the differences between EUS and MRCP as applied to the diagnosis of choledocholithiasis. These differences include not only diagnostic accuracy but also the different sizes and types of stones, economic value, and potential for technical improvements.…”

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

“…To summarize, for patients with a high risk of choledocholithiasis (as determined by clinical presentation and noninvasive imaging), proceeding directly to ERCP is the best approach [ 12 ]. For patients at low-to-moderate risk of choledocholithiasis, performing EUS or MRCP first before ERCP can prevent unnecessary ERCP [ 13 ]. Owing to apparent pros and cons between these two modalities, the choice should be based on local availability and operator expertise.…”