Prospective controlled study of endoscopic ultrasonography and endoscopic retrograde cholangiography in patients with suspected choledocholithiasis.
- Author:
Hyun Shin PARK
1
;
Myoung Shik KIM
;
Hyong Seong KANG
;
Seok JEONG
;
Jin Woo LEE
;
Kye Sook KWON
;
Don Haeng LEE
;
Pum Soo KIM
;
Hyung Gil KIM
;
Yong Woon SHIN
;
Young Soo KIM
Author Information
1. Department of Internal Medicine, College of Medicine, Inha University, Incheon, Korea. hgkim@inha.ac.kr
- Publication Type:Original Article
- Keywords:
Choledocholithiasis;
Endoscopic ultrasonography;
Endoscopic retrograde cholangiography
- MeSH:
Ampulla of Vater;
Bile Ducts;
Cholangiography*;
Cholangiopancreatography, Endoscopic Retrograde;
Choledocholithiasis*;
Cholestasis, Extrahepatic;
Common Bile Duct;
Diagnosis;
Endosonography*;
Humans;
Prospective Studies*;
Sphincterotomy, Endoscopic
- From:Korean Journal of Medicine
2004;66(5):472-477
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiography (ERC) are accurate for the diagnosis of commom bile duct stone. But sometimes, endoscopic sphincterotomy is done unnecessarily in patients with suspected choledocholithiasis. Endoscopic ultrasonography is a promising procedure for the diagnosis of extrahepatic cholestasis due to noninvasiveness and accuracy. We compared the effectiveness of endoscopic ultrasonography with endoscopic retrograde cholangiography in detecting the extrahepatic choledocholithiasis. METHODS: sixty nine patients suspected choledocholithiasis were evaluated using endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiography (ERC). Endoscopic sphincterotomy with instrumental exploration was then done when EUS or ERCP image showed the stones. RESULTS: Choledocholithiasis was confirmed in 53 (76.8%) patients. Seven patients were false negative on ERC, of whom all were true positive on endoscopic ultrasonography. Six patients false negative on ERC had small stone (<5 mm in diameter) in dilated bileduct and one patients had impacted stone on the ampulla of Vater. CONCLUSION: EUS could be an accurate for the diagnosis of choledocholithiasis and may prevent inappropriate invasive exploration of the common bile duct.
