Diagnostic value of endoscopic ultrasonography for choledocholithiasis before endoscopic retrograde cholangiopancreatography
10.3760/cma.j.issn.1007-5232.2018.03.003
- VernacularTitle:内镜超声检查在经内镜逆行胰胆管造影术前诊断胆总管结石的临床价值
- Author:
Lu XIE
1
;
Jianfeng YANG
;
Songmei LOU
;
Haitao HUANG
;
Wen LYU
;
Xiao ZHANG
;
Xiaofeng ZHANG
Author Information
1. 310006,杭州市第一人民医院消化内科
- Keywords:
Cholangiopancreatography;
endoscopic retrograde;
Cholangiopancreatography;
magnetic resonance;
Choledocholithiasis
- From:
Chinese Journal of Digestive Endoscopy
2018;35(3):163-166
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the diagnostic value of endoscopic ultrasonography(EUS)for common bile duct(CBD)stones before endoscopic retrograde cholangiopancreatography(ERCP). Methods Data of patients with suspected CBD stones admitted to The First People′s Hospital of Hangzhou from July 2012 to July 2013 were reviewed. Diagnostic efficiency and rates of complications were analyzed between patients undergoing EUS(EUS group)and MRCP(MRCP group)before ERCP, and between patients who underwent EUS and ERCP in different sessions(non-one-session group)with those in one session(one-session group). Results A total of 657 patients were included. With ERCP and follow-up results as the gold standard, the sensitivity(97.5% VS 88.4%), accuracy(96.3% VS 88.0%)and negative predictive value(88.9% VS 60.0%)of EUS in the diagnosis of CBD stones were significantly higher than those of MRCP(P<0.05). There were no significant differences between one-session group and non-one-session group in the sensitivity(97.5% VS 97.4%), specificity(91.7% VS 90.0%), positive predictive value(98.3% VS 97.4%), negative predictive value(88.0% VS 90.0%), and accuracy (96.6% VS 95.9%)in diagnosis of CBD stones(P>0.05). There were no significant differences in incidence of postoperative complications of ERCP between EUS and MRCP group[5.4%(13/242)VS 5.1%(21/415),P>0.05],and between one-session group and non-one-session group[5.5%(8/145)VS 5.2%(5/97),P>0.05].Conclusion Preoperative EUS before ERCP could increase diagnostic sensitivity and negative pridictive value of CBD stones without increasing the incidence of complications.