Diagnostic value of endoscopic ultrasonography for small common bile duct stones / 中华消化内镜杂志

ABSTRACT

To evaluate the diagnostic value of endoscopic ultrasonography (EUS) for small common bile duct stones, 60 patients diagnosed as having suspected common bile duct stones who were hospitalized in Zhongda Hospital, Southeast University from January 2018 to July 2021 were selected. All patients were examined by EUS and magnetic resonance cholangiopancreatography (MRCP) during the same hospitalization. The results of endoscopic retrograde cholangiopancreatography, laparotomy or laparoscopic common bile duct exploration were adopted as the golden standard. The diagnostic results of EUS and MRCP were compared with the golden standard, and the sensitivity, specificity, positive predictive value and negative predictive value of the two methods were calculated. Among the 60 patients, 46 cases were confirmed as having common bile duct stones, 43 cases were diagnosed accurately by EUS and 35 cases by MRCP. Fourteen patients were confirmed as having no common bile duct stones, and the diagnosis was accurate in 12 cases by EUS and 13 cases by MRCP. The sensitivity of EUS was significantly higher than that of MRCP [93.48% (43/46) VS 76.09% (35/46), χ2=4.128, P=0.042]. There were 45 cases with diameter ≤1.0 cm, of which 42 cases were diagnosed by EUS and 34 by MRCP (diagnostic accuracy 93.33% VS 75.56%, χ2=4.145, P=0.042). There were 39 cases with diameter ≤0.8 cm, of which 36 cases were diagnosed by EUS and 28 by MRCP (diagnostic accuracy 92.31% VS 71.79%, χ2=4.266, P=0.039). There were 26 cases with diameter ≤0.5 cm, of which 24 cases were diagnosed by EUS and 16 by MRCP (diagnostic accuracy 92.31% VS 61.54%, χ2=5.038, P=0.021). EUS has obvious advantages in the diagnosis of common bile duct stones, and the accuracy of EUS is not affected by the size of stone. As a consequence, EUS should be performed in patients with high clinical suspicion of common bile duct stones but negative MRCP result.