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KMID : 1038120220550010122
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Clinical Endoscopy
2022 Volume.55 No. 1 p.122 ~ p.127
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Diagnostic Value of Endoscopic Ultrasonography for Common Bile Duct Dilatation without Identifiable Etiology Detected from Cross-Sectional Imaging
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Pausawasdi Nonthalee
Hongsrisuwan Penprapai
Kamani Lubna
Maipang Kotchakon
Charatcharoenwitthaya Phunchai
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Abstract
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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.
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KEYWORD
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Common bile duct, Diagnostic imaging, Endosonography, Three-dimensional imaging
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