Endoscopic Ultrasound Versus Endoscopic Retrograde Cholangiography As A Diagnostic Tool For Patients With Dilated Common Bile Duct Of Undetermined Etiology Detected By Abdominal Ultrasound

Abstract

Abstract Background Common bile duct dilatation could result from various etiologies: choledochocholithiasis, common bile duct stricture, cholangiocarcinoma, periampullary diverticulum, pancreatic head mass, Oddi sphincter dysfunction and papillary stenosis, etc. A dilated common bile duct could denote a hidden pathological biliary condition; on the other hand it occurs in cases with advanced age or postcholecystectomy status in the absence of pathological affection. Objective The aim of this study is to compare between the accuracy of endoscopic ultrasound and endoscopic retrograde cholangiography as a diagnostic tool for patients with dilated common bile duct in whom abdominal ultrasonography could not demonstrate the cause of dilation. Methods This study was conducted on eighty (80) patients who underwent EUS and ERCP to compare between the accuracy of both as a diagnostic tool in whom TUS couldn’t demonstrate the cause of CBD dilatation, the study was performed as a retrospective analysis of prospectively collected data at TBRI (Theodor Bilharz Research Institute) after approval was obtained from the ethics and indications committee of TBRI. The study protocol was approved by the medical ethics committee of Ain Shams University and TBRI. Results In the current research study it was revealed that among 80 study subjects there were 24 cases having stone (30%), 26 cases having stricture(32.5%), benign cases were only 2 (2.5%), prominent CBD with no obstruction were4 cases (5%). Conclusion Endoscopic ultrasound is a complementary imaging modality after transabdominal ultrasound for assessment of CBD dilatation and have a crucial role in the benign and malignant periampullary tumors diagnosis additional research studies are required to be performed in a multicentric fashion considering racial and ethnic differences.