Role of Endoscopic Ultrasound in Diagnosis of Unexplained CBD Dilatation | ||||
| Al-Azhar International Medical Journal | ||||
| Volume 2024, Issue 12, December 2024 | ||||
| DOI: 10.58675/2682-339X.2794 | ||||
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| Authors | ||||
| Mahmoud Morsy1; Ahmed Dorrah2; Hussein Okasha3; Waleed Mousa2 | ||||
| 1Gastroenterology and Hepatology, Al-Ahrar Teaching Hospital, Zagazig, Egypt | ||||
| 2Gastroenterology and Hepatology, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt | ||||
| 3Internal Medicine, Cairo University, Cairo, Egypt | ||||
| Abstract | ||||
| Background: This study evaluated the role of endoscopic ultrasonography (EUS) in CBD dilatation of unknown cause since normal imaging techniques are unable to identify the etiology of CBD dilatation in many patients. Methods: This interventional study included 98 patients with unexplained common bile duct dilatation, categorized into Group 1, patients who did EUS first, and Group 2, patients who did ERCP first. All patients were subjected to EUS or ERCP according to grouping. Findings of EUS and ERCP were recorded and confirmed with either a subsequently performed complementary ERCP or EUS according to the detected pathology, surgery, and biopsy confirmed malignancy. Results: 82 cases had EUS, stones were detected in 33 (33.7%) cases, and 18(21.9%) had dilated ducts without detectable pathological cause, while 16 (19.5%) cases had tumors. While ERCP was done first on 16 patients, normal CBD was detected in 12(75%), and 4(25%) had dilated CBD due to tumors. The overall accuracy of EUS in the detection of CBD dilatation cause was 96.3%, with excellent agreement (kappa=0.948). The overall accuracy of ERCP in the detection of CBD dilatation cause was 37.3%; it showed accurate diagnosis in 6 cases of a total of 16 studied cases with fair agreement (kappa=0.348) . Conclusion: EUS is a safe and effective technique for evaluating CBDs dilatation in inconclusive imaging and can help avoid unnecessary ERCP or surgery in clinical practice. | ||||
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