Korean J Gastrointest Endosc.  2007 Oct;35(4):228-234.

Usefulness of Endoscopic Ultrasonography for Diagnosing Choledocholithiasis in Patients with Gallbladder Stones

• Koo JS
• Lee HS
• Jung SW
• Han WS
• Lee JS
• Yim HJ
• Lee SW
• Choi JH
• Kim CD
• Ryu HS

Abstract

BACKGROUND/AIMS: CBD stones (CBDS) are generally thought to originate from the gallbladder. Recently, EUS appears to be the best imaging method for making the diagnosis of CBDS. We conducted this study to evaluate the role of EUS for detecting CBDS in patients with gallbladder stones (GBS) and to determine the parameters for predicting CBDS.
METHODS
From April 2003 to March 2005, 117 GBS patients were enrolled. The patients' clinical and laboratory findings and the radiologic findings of US, EUS, CT and ERCP were reviewed. The sensitivity, specificity, PPV and NPV of EUS for detecting CBDS were evaluated by using ERCP and intraoperative CBD exploration as the gold standard for diagnosing CB.
RESULTS
A total 117 patients received EUS and no complications were encountered. After performing ERCP and/or intraoperative exploration, 62 of the patients were examined for determining the presence or absence of CBDS. EUS shows 95% sensitivity and 95% specificity for identifying CBDS. The overall agreement between EUS and ERCP was 94.8%. The patients with CBDS were older than those without CBDS. Fever, jaundice and cholangitis were more prevalent in the patients with CBDS. The results of liver function tests were elevated more frequently in the patients with CBDS (p<0.05).
CONCLUSIONS
EUS is an accurate and minimally invasive method for diagnosing CBDS. Evaluating CBD in patients with gallstones is selectively recommended according to clinical and laboratory findings.

Keyword

Endoscopic ultrasonography; Cholangiopancreatography, Endoscopic retrograde; Choledocholithiasis; Gallstones

MeSH Terms

Cholangiopancreatography, Endoscopic Retrograde
Cholangitis
Choledocholithiasis*
Diagnosis
Endosonography*
Fever
Gallbladder*
Gallstones
Humans
Jaundice
Liver Function Tests
Sensitivity and Specificity