Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging
Background/Aims Endoscopic ultrasonography (EUS) is warranted when cross-sectional imaging demonstrates common bile duct (CBD) dilatation without identifiable causes. This study aimed to assess the diagnostic performance of EUS in CBD dilatation of unknown etiology. Methods Retrospective review of p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2022-01-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://e-ce.org/upload/pdf/ce-2021-122.pdf |
| _version_ | 1797425404450963456 |
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| author | Nonthalee Pausawasdi Penprapai Hongsrisuwan Lubna Kamani Kotchakon Maipang Phunchai Charatcharoenwitthaya |
| author_facet | Nonthalee Pausawasdi Penprapai Hongsrisuwan Lubna Kamani Kotchakon Maipang Phunchai Charatcharoenwitthaya |
| author_sort | Nonthalee Pausawasdi |
| collection | DOAJ |
| description | Background/Aims Endoscopic ultrasonography (EUS) is warranted when cross-sectional imaging demonstrates common bile duct (CBD) dilatation without identifiable causes. This study aimed to assess the diagnostic performance of EUS in CBD dilatation of unknown etiology. Methods Retrospective review of patients with dilated CBD without definite causes undergoing EUS between 2012 and 2017. Results A total of 131 patients were recruited. The mean age was 63.2±14.1 years. The most common manifestation was abnormal liver chemistry (85.5%). The mean CBD diameter was 12.2±4.1 mm. The area under the receiver operating characteristic curve (AUROC) of EUS-identified pathologies, including malignancy, choledocholithiasis, and benign biliary stricture (BBS), was 0.98 (95% confidence interval [CI], 0.95-1.00). The AUROC of EUS for detecting malignancy, choledocholithiasis, and BBS was 0.91 (95% CI, 0.85-0.97), 1.00 (95% CI, 1.00-1.00), and 0.93 (95% CI, 0.87-0.99), respectively. Male sex, alanine aminotransferase ≥3× the upper limit of normal (ULN), alkaline phosphatase ≥3× the ULN, and intrahepatic duct dilatation were predictors for pathological obstruction, with odds ratios of 5.46 (95%CI, 1.74-17.1), 5.02 (95% CI, 1.48-17.0), 4.63 (95% CI, 1.1-19.6), and 4.03 (95% CI, 1.37-11.8), respectively. Conclusions EUS provides excellent diagnostic value in identifying the etiology of CBD dilatation detected by cross-sectional imaging. |
| first_indexed | 2024-03-09T08:15:39Z |
| format | Article |
| id | doaj.art-5e9f52b22e8c4220bcc7d4478e31d1b3 |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-09T08:15:39Z |
| publishDate | 2022-01-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-5e9f52b22e8c4220bcc7d4478e31d1b32023-12-02T22:22:58ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432022-01-0155112212710.5946/ce.2021.1227604Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional ImagingNonthalee Pausawasdi0Penprapai Hongsrisuwan1Lubna Kamani2Kotchakon Maipang3Phunchai Charatcharoenwitthaya4 Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand Siriraj GI Endoscopy Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, ThailandBackground/Aims Endoscopic ultrasonography (EUS) is warranted when cross-sectional imaging demonstrates common bile duct (CBD) dilatation without identifiable causes. This study aimed to assess the diagnostic performance of EUS in CBD dilatation of unknown etiology. Methods Retrospective review of patients with dilated CBD without definite causes undergoing EUS between 2012 and 2017. Results A total of 131 patients were recruited. The mean age was 63.2±14.1 years. The most common manifestation was abnormal liver chemistry (85.5%). The mean CBD diameter was 12.2±4.1 mm. The area under the receiver operating characteristic curve (AUROC) of EUS-identified pathologies, including malignancy, choledocholithiasis, and benign biliary stricture (BBS), was 0.98 (95% confidence interval [CI], 0.95-1.00). The AUROC of EUS for detecting malignancy, choledocholithiasis, and BBS was 0.91 (95% CI, 0.85-0.97), 1.00 (95% CI, 1.00-1.00), and 0.93 (95% CI, 0.87-0.99), respectively. Male sex, alanine aminotransferase ≥3× the upper limit of normal (ULN), alkaline phosphatase ≥3× the ULN, and intrahepatic duct dilatation were predictors for pathological obstruction, with odds ratios of 5.46 (95%CI, 1.74-17.1), 5.02 (95% CI, 1.48-17.0), 4.63 (95% CI, 1.1-19.6), and 4.03 (95% CI, 1.37-11.8), respectively. Conclusions EUS provides excellent diagnostic value in identifying the etiology of CBD dilatation detected by cross-sectional imaging.http://e-ce.org/upload/pdf/ce-2021-122.pdfcommon bile ductdiagnostic imagingendosonographythree-dimensional imaging |
| spellingShingle | Nonthalee Pausawasdi Penprapai Hongsrisuwan Lubna Kamani Kotchakon Maipang Phunchai Charatcharoenwitthaya Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging Clinical Endoscopy common bile duct diagnostic imaging endosonography three-dimensional imaging |
| title | Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging |
| title_full | Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging |
| title_fullStr | Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging |
| title_full_unstemmed | Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging |
| title_short | Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging |
| title_sort | diagnostic value of endoscopic ultrasonography for common bile duct dilatation without identifiable etiology detected from cross sectional imaging |
| topic | common bile duct diagnostic imaging endosonography three-dimensional imaging |
| url | http://e-ce.org/upload/pdf/ce-2021-122.pdf |
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