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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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Nonthalee Pausawasdi, Penprapai Hongsrisuwan, Lubna Kamani, Kotchakon Maipang, Phunchai Charatcharoenwitthaya
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Clin Endosc 2022;55(1):122-127. Published online January 3, 2022
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DOI: https://doi.org/10.5946/ce.2021.122
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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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Citations
Citations to this article as recorded by  - Incidental findings of gallbladder and bile ducts – Management strategies: Normal findings, anomalies, “silent gallstones” and bile duct dilatation - A World Federation of Ultrasound in Medicine and Biology (WFUMB) position paper
Christian Jenssen, Christian P. Nolsøe, Torben Lorentzen, Jae Young Lee, Nitin Chaubal, Kathleen Möller, Caroline Ewertsen, Xin Wu Cui, Edda Leonor Chaves, Alina Popescu, Yi Dong, Christoph F. Dietrich
WFUMB Ultrasound Open.2024; 2(1): 100034. CrossRef - Diagnostic yield of endoscopic ultrasound in dilated common bile duct with non-diagnostic cross-sectional imaging
Ankit Mahajan, Kshaunish Das, Kishalaya, Debashis Misra, Kausik Das, Gopal Krishna Dhali
BMC Gastroenterology.2024;[Epub] CrossRef - Role of endoscopic ultrasound in the evaluation of unexplained extrahepatic bile duct dilatation
Long-Jiang Chen, Xiao-Yi Wang, Jian-Hua Dai, Zhi-Gang Tang
European Journal of Gastroenterology & Hepatology.2023; 35(1): 73. CrossRef - The Endoscopic Retrograde Cholangiopancreatography and Endoscopic Ultrasound Connection: Unity Is Strength, or the Endoscopic Ultrasonography Retrograde Cholangiopancreatography Concept
Claudio Giovanni De Angelis, Eleonora Dall’Amico, Maria Teresa Staiano, Marcantonio Gesualdo, Mauro Bruno, Silvia Gaia, Marco Sacco, Federica Fimiano, Anna Mauriello, Simone Dibitetto, Chiara Canalis, Rosa Claudia Stasio, Alessandro Caneglias, Federica Me
Diagnostics.2023; 13(20): 3265. CrossRef - Value of Endoscopic Ultrasonography in Evaluating Unexplained Isolated Common Bile Duct Dilation on Imaging
Seifeldin Hakim, Amrita Sethi
Clinical Endoscopy.2022; 55(1): 47. CrossRef
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Ergonomic Injuries in Endoscopists and Their Risk Factors
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Lubna Kamani, Hamid Kalwar
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Clin Endosc 2021;54(3):356-362. Published online March 3, 2021
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DOI: https://doi.org/10.5946/ce.2020.200
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Abstract
PDFPubReaderePub
- Background
/Aims: Prolonged repetitive strain caused by the continuous performance of complex endoscopic procedures enhances the risk of ergonomic injuries among health-care providers (HCPs), specifically endoscopists. This study aimed to assess the risk factors of ergonomic injuries among endoscopists and non-endoscopists.
Methods
This cross-sectional study was conducted at the Gastroenterology Department of Liaquat National Hospital, Karachi, Pakistan. A total of 92 HCPs were enrolled, of whom 61 were involved in endoscopic procedures and 31 were non-endoscopists. Data were collected through a self-administered questionnaire during national gastroenterology conferences and analyzed using SPSS version 22 (IBM Corp. Chicago, IL, USA).
Results
Of the total study population, 95.08% of endoscopists were observed to have ergonomic injuries, whereas only 54.83% of non-endoscopists had ergonomic injuries (p<0.00). The most common injury associated with musculoskeletal (MSK) pain sites was back (41%), leg (23%), and hand (19.7%) pain among endoscopists. Of 28 endoscopists performing ≥20 procedures/week, 26 had MSK injury. However, 95.08% of endoscopists had developed MSK injury irrespective of working hours (>5 or <5 hr/wk).
Conclusions
Endoscopists are at high risk of developing ergonomic injuries, representing the negative potential of the endoscopy-associated workload. To overcome these issues, an appropriate strategic framework needs to be designed to avoid occupational compromises.
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Citations
Citations to this article as recorded by - Ergonomic wellness for the trainee in gastrointestinal endoscopy
Nikko Gimpaya, William T. Tran, Samir C. Grover
Current Opinion in Gastroenterology.2024; 40(5): 348. CrossRef - Work-Related Musculoskeletal Injury Rates, Risk Factors, and Ergonomics in Different Endoscopic Specialties: A Review
Veronica Bessone, Daniel B. Roppenecker, Sven Adamsen
Healthcare.2024; 12(9): 885. CrossRef - Prevalence and sex differences in endoscopy-related injuries: comprehensive systematic review and meta-analysis
Azizullah Beran, Mouhand F. Mohamed, John J. Guardiola, Tarek Aboursheid, Alejandra Vargas, Tarek Nayfeh, Khaled Elfert, Mohammad Shaear, Hala Fatima, Jeffrey J. Easler, Mohammad Al-Haddad, Nabil Fayad, Patrick Young, Samir A. Shah, Douglas K. Rex
iGIE.2024; 3(3): 401. CrossRef - Musculoskeletal injury and ergonomics in pediatric gastrointestinal endoscopic practice
Wenly Ruan, Catharine M. Walsh, Swati Pawa, Sharlene L. D’Souza, Promila Banerjee, Shivangi Kothari, Graham A. McCreath, Douglas S. Fishman
Surgical Endoscopy.2023; 37(1): 248. CrossRef - Enhancing Ergonomics in Pediatric Endoscopy Training and Practice
Catharine M. Walsh
Gastrointestinal Endoscopy Clinics of North America.2023; 33(2): 235. CrossRef - Musculoskeletal Injuries in the Endoscopy Practitioner Risk Factors, Ergonomic Challenges and Prevention—Narrative Review and Perspectives
Tadej Durič, Ivana Cibulková, Jan Hajer
Gastroenterology Insights.2023; 14(3): 352. CrossRef - American Society for Gastrointestinal Endoscopy guideline on the role of ergonomics for prevention of endoscopy-related injury: methodology and review of evidence
Swati Pawa, Richard S. Kwon, Douglas S. Fishman, Nirav C. Thosani, Amandeep Shergill, Samir C. Grover, Mohammad Al-Haddad, Stuart K. Amateau, James L. Buxbaum, Audrey H. Calderwood, Jean M. Chalhoub, Nayantara Coelho-Prabhu, Madhav Desai, Sherif E. Elhana
Gastrointestinal Endoscopy.2023; 98(4): 492. CrossRef - Protecting Gastroenterologists through Rehabilitation Training: An Overlooked Area of Concern
Sun-Hye Ko, Myong Ki Baeg
Gut and Liver.2023; 17(6): 829. CrossRef - Ergonomía en endoscopia digestiva: prevalencia, tipos de trastornos musculoesqueléticos y factores de riesgo en endoscopistas de Colombia
Camilo de Jesús Blanco Avellaneda, Robin German Prieto Ortiz, Ricardo Aníbal Cepeda Vásquez, Jose Bareño Silva, Carlos Arturo Gonzalez Salazar, Lázaro Antonio Arango Molano, Nairo Javier Senejoa Nuñez
Revista colombiana de Gastroenterología.2022; 37(2): 174. CrossRef - Gesundheitszustand des Endoskopiepersonals in Österreich
Gerlinde Weilguny-Schöfl, Werner Dolak, Martina Fellinghauer, Theresia Schober, Rainer Schöfl
Zeitschrift für Gastroenterologie.2022; 60(11): 1625. CrossRef - Musculoskeletal Pains and Their Risk Factors in Endoscopists
Gi-young Park
Clinical Endoscopy.2021; 54(3): 295. CrossRef
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3,959
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Redesigning the Landscape for Women and Leadership: Insights Gained from the Covid-19 Pandemic. On Behalf of Women in Gastroenterology Network Asia Pacific (WIGNAP) and Women in Endoscopy (WIE)
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Lubna Kamani, Nonthalee Pausawasdi, Jeanin E.Van Hooft, Amrita Sethi, Sharmila Sachithanandan
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Clin Endosc 2020;53(5):620-622. Published online September 29, 2020
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DOI: https://doi.org/10.5946/ce.2020.202
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PDFPubReaderePub
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Citations
Citations to this article as recorded by - The Emerging Leaders Committee: Turning a new page for APAGE to nurture the next generation of Asia‐Pacific leaders in digestive health
Rashid N. Lui, Ting Ting Chan, Tanyaporn Chantarojanasiri, Mu‐Ming Chien, Viet‐Hang Dao, Jalpa Devi, Daniel Q. Huang, Eun‐Hyo Jin, Tsevelnorov Khurelbaatar, Zaheer Nabi, Koji Otani, Mara Teresa T. Panlilio, Sang Hyoung Park, Rabbinu Rangga Pribadi, Yuqi Q
Journal of Gastroenterology and Hepatology.2024; 39(8): 1453. CrossRef
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