Accuracy of endosonography in the diagnosis of obstructive jaundice

Endoscopic retrograde cholangiopancreatography [ERCP] has been used as the method of choice in assessment of obstructive jaundice for a long time. Recently, the development of endoscopic ultrasonography [EUS] has attracted the attention of clinicians as an alternative accurate, safe and cheap method to replace the ERCP procedures performed only for diagnostic purposes, the present study aims to examine the accuracy of endoscopic ultrasonography as an alternative diagnostic procedure to ERCP for detection of causes of cholestasis'. In this study, 100 patients underwent endoscopic ultrasonography in Digestive Disease Research Center, Shariati Hospital. The patients were divided into two groups: 1] those with operable periampullary tumors who were referred to the surgeons, 2] other patients. The final diagnosis made after ERCP and operative removal of the mass was considered as the gold standard and was compared with accuracy of endoscopic ultrasonography. The overall accuracy of endoscopic ultrasonography in the diagnosis of obstructive cholestasis was 92.0%. Sensitivity and specificity of this method in diagnosis of choledocholithiasis were 95.2% and 96.4% respectively. The corresponding values for diagnosis of periampullary tumors were 96.2% and 95.8%.In this study the accuracy of EUS in diagnosis of obstructive jaundice and its sensitivity and specificity for diagnosis of choledocholithiasis and periampullary tumors were high. Therefore, it could be concluded that endoscopic ultrasonography is a reliable diagnostic tool for extrahepatic cholestasis