Korean J Med.  2004 May;66(5):472-477.

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

• Park HS
• Kim MS
• Kang HS
• Jeong S
• Lee JW
• Kwon KS
• Lee DH
• Kim PS
• Kim HG
• Shin YW
• Kim YS

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.

Keyword

Choledocholithiasis; Endoscopic ultrasonography; Endoscopic retrograde cholangiography

MeSH Terms

Ampulla of Vater
Bile Ducts
Cholangiography*
Cholangiopancreatography, Endoscopic Retrograde
Choledocholithiasis*
Cholestasis, Extrahepatic
Common Bile Duct
Diagnosis
Endosonography*
Humans
Prospective Studies*
Sphincterotomy, Endoscopic