Prospective evaluation of early endoscopic ultrasonography for triage in suspected choledocholithiasis: Results from a large single centre series

被引:24
作者
Anderloni, Andrea [1 ]
Ballare, Marco [1 ]
Pagliarulo, Michela [1 ]
Conte, Dario [2 ,3 ]
Galeazzi, Marianna [1 ]
Orsello, Marco [1 ]
Andorno, Silvano [4 ]
Del Piano, Mario [1 ]
机构
[1] AOU Maggiore della Carita, Gastrointestinal & Digest Endoscopy Unit, I-28100 Novara, Italy
[2] Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Gastrointestinal Unit 2, Milan, Italy
[3] Univ Milan, Milan, Italy
[4] Univ Piemonte Orientale, Dept Med Sci, Unit Med Stat & Epidemiol, Novara, Italy
关键词
Choledocholithiasis; Endoscopic ultrasonography; ERCP; COMMON BILE-DUCT; MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY; ACUTE BILIARY PANCREATITIS; RETROGRADE CHOLANGIOPANCREATOGRAPHY; STONES PRIOR; EUS; CHOLANGIOGRAPHY; ERCP; PREDICTION; MANAGEMENT;
D O I
10.1016/j.dld.2013.11.007
中图分类号
R57 [消化系及腹部疾病];
学科分类号
100201 [内科学];
摘要
Background: Endoscopic ultrasonography is accurate, safe, and cost-effective in diagnosing common bile duct stones, thus suggesting the possibility to avoid invasive endoscopic retrograde cholangiopancreatography. Aim: To prospectively evaluate the diagnostic and therapeutic performance of early endoscopic ultrasonography in suspected choledocholithiasis. Patients and methods: All consecutive patients presenting to the Emergency Department with suspicion of choledocholithiasis between January 2010 and January 2012 were evaluated and categorized as low, moderate, or high probability of choledocholithiasis, according to accepted criteria. Endoscopic endosonography was carried out within 48 h from the admission and endoscopic retrograde cholangiopancreatography was performed soon in case of confirmed choledocholithiasis. Results: Overall 179 patients were included: 48 (26.8%) were classified as low, 65 (36.3%) as moderate, and 66 (36.9%) as high probability of choledocholithiasis. Of the 86 patients with common bile duct stones at endoscopic endosonography, endoscopic retrograde cholangiopancreatography confirmed the finding in 79 (92%). By multivariate analysis only the common bile duct diameter proved an independent predictor of common bile duct stones. Conclusions: Early endoscopic endosonography is accurate in identifying choledocholithiasis allowing immediate endoscopic treatment and significant spare of unnecessary endoscopic retrograde cholangiopancreatography. This approach can be useful as a triage test to select patients not needing endoscopic retrograde cholangiopancreatography, allowing, in selected cases, their early discharge. (C) 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:335 / 339
页数:5
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