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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
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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
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Seifeldin Hakim, Amrita Sethi
Clinical Endoscopy.2022; 55(1): 47. CrossRef
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