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P-HPB-12: The utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging
BACKGROUND: Endoscopic ultrasonography (EUS) is frequently being performed when common bile duct (CBD) dilatation is detected on cross-sectional imaging without identifiable causes. OBJECTIVES: To assess the diagnostic yield of EUS in patients with inconclusive cause of CBD dilatation detected by cr...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Medknow Publications & Media Pvt Ltd
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569785/ http://dx.doi.org/10.4103/2303-9027.212331 |
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author | Hongsrisuwan, Penprapai Pausawasdi, Nonthalee |
author_facet | Hongsrisuwan, Penprapai Pausawasdi, Nonthalee |
author_sort | Hongsrisuwan, Penprapai |
collection | PubMed |
description | BACKGROUND: Endoscopic ultrasonography (EUS) is frequently being performed when common bile duct (CBD) dilatation is detected on cross-sectional imaging without identifiable causes. OBJECTIVES: To assess the diagnostic yield of EUS in patients with inconclusive cause of CBD dilatation detected by cross-sectional imaging. METHODS: This was a retrospective review of patients with dilated CBD on either computed tomography (CT) or magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) without definite cause undergoing EUS during 2008–2015. RESULTS: A total of 131 patients were recruited (mean age 63, 47% males). The mean diameter of CBD on CT or MRI/MRCP was 12 mm. The etiology of CBD dilatation was identified in 88/131 (67%) patients. Among these, 47% had malignant obstruction with distal cholangiocarcinoma being the most common cancer (51%), 27% had bile duct stone, and 26% had benign stricture. EUS offers an accuracy of 98% in the detection of pathological CBD dilatation. In addition, it is 100% accurate for CBD stone detection, 93% accurate for both malignant and benign obstruction, and 100% specific in cases of nonpathological CBD dilatation. Multivariate analysis indicated that male gender, serum glutamic-pyruvic transaminase = 3 × upper limit of normal (ULN), alkaline phosphatase (ALP) = 3 × ULN, and intrahepatic duct (IHD) dilatation were predictors of pathological obstruction with the odds ratio of 5.46, 5.02, 4.63, and 4.03, respectively. In contrast, ALP = 2 × ULN, female gender, and no IHD dilatation were predictive of nonpathological CBD dilatation with the odds ratio of 7.15, 5.18, and 4.12, respectively. CONCLUSION: EUS is essential in the evaluation of CBD dilatation in inconclusive CT or MRI/MRCP and thus should be performed routinely when clinically or biochemistry indicative of pancreatobiliary diseases. |
format | Online Article Text |
id | pubmed-5569785 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Medknow Publications & Media Pvt Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-55697852017-09-01 P-HPB-12: The utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging Hongsrisuwan, Penprapai Pausawasdi, Nonthalee Endosc Ultrasound Abstract BACKGROUND: Endoscopic ultrasonography (EUS) is frequently being performed when common bile duct (CBD) dilatation is detected on cross-sectional imaging without identifiable causes. OBJECTIVES: To assess the diagnostic yield of EUS in patients with inconclusive cause of CBD dilatation detected by cross-sectional imaging. METHODS: This was a retrospective review of patients with dilated CBD on either computed tomography (CT) or magnetic resonance imaging/magnetic resonance cholangiopancreatography (MRI/MRCP) without definite cause undergoing EUS during 2008–2015. RESULTS: A total of 131 patients were recruited (mean age 63, 47% males). The mean diameter of CBD on CT or MRI/MRCP was 12 mm. The etiology of CBD dilatation was identified in 88/131 (67%) patients. Among these, 47% had malignant obstruction with distal cholangiocarcinoma being the most common cancer (51%), 27% had bile duct stone, and 26% had benign stricture. EUS offers an accuracy of 98% in the detection of pathological CBD dilatation. In addition, it is 100% accurate for CBD stone detection, 93% accurate for both malignant and benign obstruction, and 100% specific in cases of nonpathological CBD dilatation. Multivariate analysis indicated that male gender, serum glutamic-pyruvic transaminase = 3 × upper limit of normal (ULN), alkaline phosphatase (ALP) = 3 × ULN, and intrahepatic duct (IHD) dilatation were predictors of pathological obstruction with the odds ratio of 5.46, 5.02, 4.63, and 4.03, respectively. In contrast, ALP = 2 × ULN, female gender, and no IHD dilatation were predictive of nonpathological CBD dilatation with the odds ratio of 7.15, 5.18, and 4.12, respectively. CONCLUSION: EUS is essential in the evaluation of CBD dilatation in inconclusive CT or MRI/MRCP and thus should be performed routinely when clinically or biochemistry indicative of pancreatobiliary diseases. Medknow Publications & Media Pvt Ltd 2017-08 /pmc/articles/PMC5569785/ http://dx.doi.org/10.4103/2303-9027.212331 Text en Copyright: © 2017 Endoscopic Ultrasound http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. |
spellingShingle | Abstract Hongsrisuwan, Penprapai Pausawasdi, Nonthalee P-HPB-12: The utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging |
title | P-HPB-12: The utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging |
title_full | P-HPB-12: The utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging |
title_fullStr | P-HPB-12: The utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging |
title_full_unstemmed | P-HPB-12: The utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging |
title_short | P-HPB-12: The utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging |
title_sort | p-hpb-12: the utility of endoscopic ultrasonography in common bile duct dilatation of unknown etiology detected from cross-sectional imaging |
topic | Abstract |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5569785/ http://dx.doi.org/10.4103/2303-9027.212331 |
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