TY - JOUR
T1 - Prospective evaluation of early endoscopic ultrasonography for triage in suspected choledocholithiasis
T2 - Results from a large single centre series
AU - Anderloni, Andrea
AU - Ballarè, Marco
AU - Pagliarulo, Michela
AU - Conte, Dario
AU - Galeazzi, Marianna
AU - Orsello, Marco
AU - Andorno, Silvano
AU - Del Piano, Mario
PY - 2014
Y1 - 2014
N2 - 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.
AB - 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.
KW - Choledocholithiasis
KW - Endoscopic ultrasonography
KW - ERCP
UR - http://www.scopus.com/inward/record.url?scp=84895520155&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84895520155&partnerID=8YFLogxK
U2 - 10.1016/j.dld.2013.11.007
DO - 10.1016/j.dld.2013.11.007
M3 - Article
C2 - 24380748
AN - SCOPUS:84895520155
VL - 46
SP - 335
EP - 339
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 4
ER -