Diagnostic value of endoscopic ultrasonography in patients with biliary-pancreatic duct dilatation

Abstract

Objective To study the diagnostic value of endoscopic ultrasonography (EUS) in patients with cholangiopancreatic duct dilatation (CPDD). Methods Forty-five patients with CPDD and without any visual or detected obstructive lesions after traditional ultrasonography (US) were re-examined by EUS, CT and MRI. The diagnostic rates of EUS and the other imaging technologies were compared. Results All the 45 patients underwent successful EUS examination. Among them, there were 18 patients with periampullary tumor, 10 patients with lower common bile duct stones, 1 patient with pancreatic duct stones, 3 patients with chronic pancreatitis, 1 patient with an intrapancreatic choledochal cyst, 4 patients with inflammatory strictures of papilla of duodenum and 2 patients with terminal bile duct inflammatory stenosis. However, 1 patient with a lower common bile duct tumor, 1 patient with a small pancreatic head carcinoma and 1 patient with sphincter of Oddi dysfunction (SOD) were not diagnosed. The diagnostic rates of obstructive lesions by US, EUS, CT and MRI were 7.1%, 92.9%, 33.3%, 31.0%, respectively. The diagnostic rates of tumor were 10.0%, 90.0%, 35.0%, 25.0%, respectively. As compared with the other examination methods, EUS was best in detecting small carcinoma. Conclusion EUS plays an important role in the diagnosis of lesions causing cholangiopancreatic duct dilatation. Key words: Ultrasonography; Bile duct diseases; Pancreatic ducts; Endoscopic ultrasonography; Diagnosis