Diagnostic Utility of Endoscopic Ultrasonograpy (EUS) for Common Bile Duct (CBD) Stones not Confirmed by Endoscopic Retrograde Cholangiopancreatography (ERCP).
- Author:
Hong Bae PARK
1
;
Hyang Soon YEO
;
Myung Weon KANG
;
Yeun Keun LIM
;
Dong Goo KANG
;
Eun Woo LEE
;
Do Hyun KIM
;
Youn Ah KIM
;
Hyuck PARK
Author Information
1. Department of Internal Medicine, Kwangju Christian Hospital.
- Publication Type:Original Article
- Keywords:
Endoscopic ultrasonography;
Endoscopic retrograde cholangio-pancreato-graphy;
Common bile duct stones
- MeSH:
Ampulla of Vater;
Catheterization;
Cholangiopancreatography, Endoscopic Retrograde*;
Common Bile Duct*;
Diagnosis;
Endosonography;
Fistula;
Humans;
Pancreatitis;
Sphincterotomy, Endoscopic
- From:Korean Journal of Gastrointestinal Endoscopy
1999;19(3):394-401
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND AIMS: Endoscopic retrograde cholangiopancreatography (ERCP) is the best imaging procedure for the diagnosis of common bile duct (CBD) stones. But the difficulties of diagnosis are mostly due to problems involving cannulation, microlithiasis and pancreatitis etc. The diagnostic utility of endoscopic ultrasonography (EUS) for the diagnosis of CBD stones not detected by ERCP was retrogradely assessed in 8 patients. METHODS: All the patients (N=98) underwent ERCP, and in the case where CBD stones were not confirmed by ERCP, EUS was performed. Final diagnosis was determined by ERCP with an endoscopic sphincterotomy (EST) or operative exploration. RESULTS: 98 patients with CBD stones were studied. The first ERCP successfully imaged CBD stones in 90 patients and an EST was performed in 84 patients. In 6 patients, stones were removed through operative exploration. ERCP images were incomplete or of poor quality in 8 patients. EUS images were excellent or good in all 8 cases, where ERCP was ineffective. Factors associated with incomplete results for CBD stones included; inability to cannulate the ampulla of Vater (N=1), nonvisualized CBD (N=4), microlithiasis (N=2), and association with the periampullary fistula (N=1). The second ERCP and EST successfully confirmed the diagnosis of CBD stones in 6 patients. In 2 patients, operative exploration was needed to confirm the diagnosis of CBD stones. CONCLUSIONS: An EUS appears to be an accurate and useful diagnostic tool for assessing CBD stones in cases where an ERCP was ineffective.
