Abstract
Background. In order to assess the diagnostic accuracy of linear EUS for evaluating clinically suggestive CBD stones in high-risk groups. Methods. 202 patients with clinically suggestive CBD stones in high-risk groups who underwent linear EUS examination between January 2012 and January 2015 were retrospectively reviewed. Endoscopic retrograde cholangiopancreatography (ERCP) with stone extraction or surgical choledochoscopy was only performed when a CBD stone was detected by linear EUS. Cases that were negative for CBD stones were followed up for at least 6 months. Results. Of 202 enrolled patients, 126 were positive for CBD stones according to linear EUS findings. 124 patients successfully underwent ERCP, and ERCP failed in 2 who were later successfully treated by surgical intervention. There were 2 false-positive cases with positive findings for CBD stones on ERCP. Among 76 patients without CBD stones, no false-negative cases were identified during the mean 6-month follow-up. Linear EUS had sensitivity, specificity, and positive and negative predictive values for the detection of CBD stones of 100%, 92.88%, 98.21%, and 100%, respectively. Conclusions. Linear EUS is a safe and efficacious diagnostic tool for evaluating clinically suggestive CBD stones with high risk of choledocholithiasis. Performing linear EUS prior to ERCP in patients with symptoms suggestive of CBD stones can reduce unnecessary ERCP procedures.
Highlights
Common bile duct (CBD) stones are a common clinical problem; their etiology is not well understood, and they can cause serious complications [1]
We report our experience with the diagnostic accuracy of linear EUS for evaluating symptoms suggestive of CBD stones which fulfill the criteria for a high likelihood of choledocholithiasis [8]
Compared to EUS, the rate of detecting CBD stones with magnetic resonance cholangiopancreatography (MRCP) is associated with the size of the stone
Summary
Common bile duct (CBD) stones are a common clinical problem; their etiology is not well understood, and they can cause serious complications [1]. We report our experience with the diagnostic accuracy of linear EUS for evaluating symptoms suggestive of CBD stones which fulfill the criteria for a high likelihood of choledocholithiasis [8]. In order to assess the diagnostic accuracy of linear EUS for evaluating clinically suggestive CBD stones in high-risk groups. 202 patients with clinically suggestive CBD stones in high-risk groups who underwent linear EUS examination between January 2012 and January 2015 were retrospectively reviewed. Among 76 patients without CBD stones, no false-negative cases were identified during the mean 6-month follow-up. Linear EUS is a safe and efficacious diagnostic tool for evaluating clinically suggestive CBD stones with high risk of choledocholithiasis. Performing linear EUS prior to ERCP in patients with symptoms suggestive of CBD stones can reduce unnecessary ERCP procedures
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