Clinical value of endoscopic ultrasonography in diagnosis and treatment of common bile duct dilatation

Abstract

Objective To investigate the value of endoscopic ultrasonography (EUS) in the diagnosis and treatment of undetermined etiology of common bile duct (CBD) dilatation. Methods Patients, who were referred for dilated CBD but unable to identify the cause by imaging, underwent EUS for the diagnosis of etiology in Endoscopy Center of Zhongshan Hospital Affiliated to Fudan University from December 2015 to December 2016. The therapy was on the basis of diagnosis of EUS. Final diagnoses were determined by surgical pathology or follow-up for at least 3 months. Results A total of 76 patients were included in the study. The sensitivity, specificity and accuracy of EUS for patients with choledocholithiasis, patients with ampullary tumor, and patients with inflammatory stenosis were 100.0% (7/7), 100.0% (69/69), 100.0% (76/76), and 88.0% (22/25), 92.2% (47/51), 90.8% (69/76), and 90.9% (40/44), 93.8% (29/32), 90.8% (69/76), respectively. Accuracy of EUS for etiological diagnosis of CBD dilatation was 90.8% (69/76). The sensitivity, specificity and accuracy of EUS combined with tumor markers for patients with malignant CBD dilatation were 96.0% (24/25), 96.1% (49/51), and 96.1% (73/76), respectively. Conclusion EUS is an effective method for the etiological diagnosis of CBD dilatation and has guiding significance for the treatment. EUS combined with tumor markers may benefit differential diagnosis of benign and malignant CBD dilatation. Key words: Endoscopic ultrasonography; Common bile duct dilatation; Diagnosis, differential