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
1. Fernández-Esparrach G, Ginès A, Sánchez M, et al. Comparison of endoscopic ultrasonography and magnetic resonance cholangiopancreatography in the diagnosis of pancreatobiliary diseases: a prospective study. Am J Gastroenterol. 2007 Aug;102(8):1632–9.
2. Smith I, Monkemuller K, Wilcox CM. Incidentally Identified Common Bile Duct Dilatation: A Systematic Review of Evaluation, Causes, and Outcome. J Clin Gastroenterol. 2015 Dec;49(10):810–5.
3. Bruno M, Brizzi RF, Mezzabotta L, et al. Unexplained common bile duct dilatation with normal serum liver enzymes: diagnostic yield of endoscopic ultrasound and follow-up of this condition. J Clin Gastroenterol. 2014 Sep;48(8):e67-70.
4. Williams E, Beckingham I, El Sayed G, et al. Updated guideline on the management of common bile duct stones (CBDS). Gut. 2017;66(5):765–82.
5. Carriere V, Conway J, Evans J, et al. Which patients with dilated common bile and/or pancreatic ducts have positive findings on EUS? J Interv Gastroenterol. 2012 Oct;2(4):168–71.
6. Malik S, Kaushik N, Khalid A, et al. EUS yield in evaluating biliary dilatation in patients with normal serum liver enzymes. Dig Dis Sci. 2007 Feb;52(2):508–12.
7. De Angelis C, Marietti M, Bruno M, et al. Endoscopic ultrasound in common bile duct dilatation with normal liver enzymes. World J Gastrointest Endosc. 2015 Jul 10;7(8):799–805.
8. Rana SS, Bhasin DK, Sharma V, et al. Role of endoscopic ultrasound in evaluation of unexplained common bile duct dilatation on magnetic resonance cholangiopancreatography. Ann Gastroenterol Q Publ Hell Soc Gastroenterol. 2013;26(1):66–70.
9. Vaynshtein J, Sabbag G, Pinsk I, et al. Predictors for choledocholitiasis in patients undergoing endoscopic ultrasound. Scand J Gastroenterol. 2018 Mar;53(3):335–9.
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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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