Detection Of Choledocholithiasis Using Endoscopic Ultrasanography – One Centre's Experience

Aims: To evaluate the utility of endoscopic ultrasonography (EUS) in assessing patients with biliary symptoms and to compare the sensitivity of EUS with other modalities in the detection of choledocholithiasis (CDL).

Methods: We conducted a retrospective analysis of all patients referred with biliary symptoms between 19–2006.

Results: 278 patients were referred; of these EUS detected CDL in 63 (23%); all of which were confirmed at ERCP. The average stone size was 7.8mm and most were located in the distal duct. Of the 63 patients with confirmed CDL at EUS 58 (92%) had had previous imaging to investigate the same symptoms –47 a previous transabdominal ultrasound (USAB), 10 a previous Computed Tomography (CT) and 20 a previous Magnetic Resonance Cholangiopancreatography (MRCP). A normal CBD with no evidence of CDL was reported in 27 (57%) USABs, 3 (30%) CTs and 11 (55%) MRCPs. The average CBD size as assessed by EUS in this group was 7.7mm and the average stone diameter was 6.7mm; most were located in the distal duct.

Conclusions: This study confirms the high sensitivity of EUS in diagnosing CDL and suggests that it should become a standard part of the diagnostic work up of these patients.