Diagnostic accuracy of ultrasonography and percutaneous transhepatic cholangiography in pereoperative evaluation of obstructive jaundice

ABSTRACT

A study was conducted in Radiology Department, Combined Military Hospital, Rawalpindi to determine the combined efficacy of Ultrasonography [USG] and Percutaneous Transhepatic Cholangiography [PTC] in the preoperative evaluation of obstructive jaundice. After initial screening by means of Ultrasonography, 22 patients were selected for PTC. Of them 14 underwent surgery, providing an opportunity for assessing the separate and combined accuracy of both the modalities. Both were equally accurate detecting stones in the common bile duct [100%]. In assessing stones of the gallbladder, USG [100%] was found to be superior to PTC [0%]. Similarly, USG [87.5%], outperformed PTC [37.5%] in identifying enlargements of the gallbladder. PTC [87.5%] however, surpassed USG [28.5%] in detecting extrinsic compression of the common bile duct [CBD] by nepotistic pancreatic enlargements. Combination of these two modalities resulted in a much improved diagnostic yield and proved to be an economical and safe yet formidable means of preoperative assessment of obstructive jaundice without the need for the more expensive CT scan, or the less available endoscopic retrograde cholangiopancreatography [ERCP]