Abstract
Background: Endoscopic ultrasonography (EUS) and transadominal ultrasonography (TUS) are two imaging investigations which can be used to assess pancreatobiliary status, although both of these imaging techniques are operator and machine dependent, but they have different sensitivity and specificity in detecting pancreatobiliary diseases. Objective: To compare the diagnostic value of EUS versus TUS in the assessment of pancreatobiliary diseases. Patients and Methods: This study was conducted in KCGH (Kurdistan Center for Gastroenterology and Hepatology) in Sulaimani city. Iraqi Kurdistan; the duration of study was 14 months and conducted after approval of Iraqi board ethical committee. One hundred cases were enrolled in the study: 52 of them were females and 48 were males; their ages ranged between 16 - 90 years; informed consent was taken from all patients; all patients underwent proper clinical evaluation; TUS, EUS and Oesophagogastroduodenoscopy (OGD), and in some of them (25 patients) Endoscopic Retrograde Cholangiopancreatography (ERCP), CT scan of abdomen and laboratory investigations were done. Results: EUS detected more cases with common bile duct (CBD) dilatation, CBD stones and pancreatic space occupying lesion (SOL) than TUS, but the differences in the results were not statistically significant. Also EUS detected more cases of intra-abdominal lymph nodes (LNs) and ampullary/peri-ampullary neoplasms than TUS and the differences in the results were statistically significant. Conclusions: Eus is more sensitive than TUS in diagnosing CBD dilatation; it has higher sensitivity than TUS in suspected pancreatobiliary neoplasms; furthermore, EUS can be used for staging and resectability assessment of pancreatobiliary neoplasia.
Highlights
IntroductionDiagnostic ultrasonography is a relatively recently developed technology
Which supports the current study result which showed sensitivity of Endoscopic ultrasonography (EUS) is higher than transadominal ultrasonography (TUS) for detecting common bile duct (CBD) dilatation, the difference was statistically insignificant in this study which could be due to the small number of patients enrolled in the study, experience and operator factors, and another important explanation is that this study was done for pancreatobiliary diseases in general; that’s to say not concentrating on CBD dilatation as done in the above studies on CBD diseases
2) CBD stones This study showed that sensitivity of EUS for detecting choledocholithiasis was 63% compared to52% by TUS, while specificity for EUS in this study was 36% compared to 21% by TUS when comparing EUS and TUS by Endoscopic Retrograde Cholangiopancreatography (ERCP)
Summary
Diagnostic ultrasonography is a relatively recently developed technology. In an effort to overcome these limitations, endoscopic ultrasound was developed in the early 1980s [2]. Endoscopic ultrasonography (EUS) and transadominal ultrasonography (TUS) are two imaging investigations which can be used to assess pancreatobiliary status, both of these imaging techniques are operator and machine dependent, but they have different sensitivity and specificity in detecting pancreatobiliary diseases. Results: EUS detected more cases with common bile duct (CBD) dilatation, CBD stones and pancreatic space occupying lesion (SOL) than TUS, but the differences in the results were not statistically significant. EUS detected more cases of intra-abdominal lymph nodes (LNs) and ampullary/peri-ampullary neoplasms than TUS and the differences in the results were statistically significant. Conclusions: Eus is more sensitive than TUS in diagnosing CBD dilatation; it has higher sensitivity than TUS in suspected pancreatobiliary neoplasms; EUS can be used for staging and resectability assessment of pancreatobiliary neoplasia
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