Endoscopy 2019; 51(04): S132
DOI: 10.1055/s-0039-1681559
ESGE Days 2019 ePoster podium presentations
Friday, April 5, 2019 10:30 – 11:00: EUS diagnosis pancreatobiliary ePoster Podium 5
Georg Thieme Verlag KG Stuttgart · New York

HIGH DIAGNOSTIC ACCURACY OF ENDOSCOPIC ULTRASONOGRAPHY IN PATIENTS WITH SUSPECTED CHOLEDOCHOLITHIASIS

B Keczer
1   Center for Therapeutic Endoscopy, 1st Department of Surgery, Semmelweis University, Budapest, Hungary
,
Z Dubravcsik
2   Bács-Kiskun County University Teaching Hospital, Kecskemét, Hungary
,
A Szepes
2   Bács-Kiskun County University Teaching Hospital, Kecskemét, Hungary
,
L Madácsy
2   Bács-Kiskun County University Teaching Hospital, Kecskemét, Hungary
,
L Harsányi
1   Center for Therapeutic Endoscopy, 1st Department of Surgery, Semmelweis University, Budapest, Hungary
,
A Szijártó
1   Center for Therapeutic Endoscopy, 1st Department of Surgery, Semmelweis University, Budapest, Hungary
,
I Hritz
1   Center for Therapeutic Endoscopy, 1st Department of Surgery, Semmelweis University, Budapest, Hungary
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aims:

The likelihood of common bile duct (CBD) stones can be prognosticated by various clinical predictors, however the sensitivity and specificity of these factors is moderate. Endoscopic ultrasonography (EUS) has been shown to be a non-invasive precise test for the detection of CBD stones. Our aim was to assess the diagnostic accuracy of EUS in patients with suspected choledocholithiasis in two centers during the period of 1 year.

Methods:

Prospective study of patients with cholelithiasis and clinical symptoms associated with abnormal liver function tests or suspicion of biliary obstruction due to stones detected by imaging modalities were categorized and divided into an intermediate- and high likelihood groups according to the clinical predictors defined by the ASGE guidelines and referred for linear EUS.

Results:

Total of 95 patients (70 females, 25 males; mean age of 60.9 ± 19.1 and 61.3 ± 17.8 years, respectively) were assessed. CBD stones were detected by EUS overall in 53 (55%) patients: 41% (20/49) in the intermediate likelihood and 72% (33/46) in the high likelihood group of patients, respectively. The size and the number of detected CBD stones in all patients were confirmed by the following endoscopic retrograde cholangio-pancreatography (ERCP). No significant difference was observed between the two likelihood groups concerning the detection of CBD stones. Two-month follow up of patients with no CBD stones detected on EUS revealed clinical findings in 4% (2/42) suspicious for biliary obstruction; 1 ERCP had to be performed in the follow-up period. The specificity and sensitivity of EUS was 100% and 95%, the positive predictive value and negative predictive value was 100% and 93%, respectively. No correlation was found between the stones detected by ERCP and the analyzed liver function tests.

Conclusions:

EUS is highly sensitive and accurate diagnostic tool for the detection and evaluation of CBD stones also in patients with previous normal imaging findings.