Year 2019 / Volume 111 / Number 10
Original
Diagnostic yield of endoscopic ultrasonography for dilation of common bile duct of indeterminate cause

757-759

DOI: 10.17235/reed.2019.6278/2019

Mafalda Sousa, Sónia Fernandes, Luísa Proença, Carlos Fernandes, João Silva, Ana Catarina Gomes, Edgar Afecto, João Carvalho,

Abstract
Introduction: with the widespread use of abdominal imaging, common bile duct (CBD) dilation is a common problem in the daily practice. However, the significance of a dilated CBD as a predictor of underlying disease has not been well elucidated and there are currently no guidelines for its approach. Methods: this was a retrospective study of patients who underwent endoscopic ultrasonography (EUS) from 2010 to 2017 due to a dilated CBD detected by transabdominal ultrasonography TUS (CBD ≥ 7 mm) or computed tomography (CT) (CBD ≥ 10 mm), with no identified cause (n = 56). The aims were to assess the diagnostic yield of EUS and to identify predictors for a positive EUS. Results: the majority of patients (n = 39) had normal findings on EUS. Abnormal EUS findings were found in 30% (n = 17) of the patients, which included choledocholithiasis (n = 6), ampuloma (n = 3), choledochal cyst (n = 2), benign CBD stenosis (n = 2), cyst of the head of the pancreas (n = 1), cholangiocarcinoma (n = 1), chronic pancreatitis (n = 1) and CBD compression due to adenomegaly (n = 1). Factors that positively related with findings on EUS were increased levels of gamma glutamyl transferase (331 U/l vs 104 U/l, p = 0.039), alkaline phosphatase (226 U/l vs 114 U/l, p = 0.041), total bilirubin (TB) (6.5 g/dl vs 1.2 g/dl, p = 0.035) and the presence of signs/symptoms (p = 0.042). Of the 21 patients (38%) who were asymptomatic with normal liver biochemical tests, four (19%) had findings on EUS. Conclusions: the majority of patients with a dilation of the CDB have a normal EUS. Increased cholestasis enzymes, increased TB and the presence of signs and symptoms are predictors of a positive EUS.
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References
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Sousa M, Fernandes S, Proença L, Fernandes C, Silva J, Gomes A, et all. Diagnostic yield of endoscopic ultrasonography for dilation of common bile duct of indeterminate cause. 6278/2019


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Publication history

Received: 12/03/2019

Accepted: 19/04/2019

Online First: 02/08/2019

Published: 03/10/2019

Article revision time: 29 days

Article Online First time: 143 days

Article editing time: 205 days


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