Prospective controlled study of endoscopic ultrasonography and endoscopic retrograde cholangiography in patients with suspected choledocholithiasis / 대한내과학회지

ABSTRACT

BACKGROUND: Endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiography (ERC) are accurate for the diagnosis of commom bile duct stone. But sometimes, endoscopic sphincterotomy is done unnecessarily in patients with suspected choledocholithiasis. Endoscopic ultrasonography is a promising procedure for the diagnosis of extrahepatic cholestasis due to noninvasiveness and accuracy. We compared the effectiveness of endoscopic ultrasonography with endoscopic retrograde cholangiography in detecting the extrahepatic choledocholithiasis. METHODS: sixty nine patients suspected choledocholithiasis were evaluated using endoscopic ultrasonography (EUS) and endoscopic retrograde cholangiography (ERC). Endoscopic sphincterotomy with instrumental exploration was then done when EUS or ERCP image showed the stones. RESULTS: Choledocholithiasis was confirmed in 53 (76.8%) patients. Seven patients were false negative on ERC, of whom all were true positive on endoscopic ultrasonography. Six patients false negative on ERC had small stone (<5 mm in diameter) in dilated bileduct and one patients had impacted stone on the ampulla of Vater. CONCLUSION: EUS could be an accurate for the diagnosis of choledocholithiasis and may prevent inappropriate invasive exploration of the common bile duct.