Photo Credit: Marina113

The following is a summary of “Diagnostic yield of endoscopic ultrasound in dilated common bile duct with non-diagnostic cross-sectional imaging,” published in the September 2024 issue of Gastroenterology by Mahajan et al.

Researchers conducted a study to determine the effectiveness of endoscopic ultrasound (EUS) in diagnosing enlarged bile ducts without a clear cause.

They analyzed consecutive patients with biliary dilatation and non-diagnostic computed tomography (CT) and/or magnetic resonance imaging (MRI) who underwent EUS with or without fine needle aspiration cytology (FNAC) and were monitored clinically, biochemically, and sometimes radiologically for up to six months. Verified EUS findings with histopathology from surgical specimens and endoscopic retrograde cholangiography (ERCP) results where applicable.

The results showed that the median age of 121 patients who completed follow-up was 55. Symptoms were present in 98.2% of patients, and the median common bile duct (CBD) diameter was 13 mm; EUS detected lesions responsible for biliary dilatation in 55.4% (67 out of 121) cases, with ampullary neoplasm being the most common at 43% (29 out of 67). Multivariate logistic regression revealed jaundice as a predictor for positive EUS findings, including ampullary and pancreatic lesions. EUS demonstrated sensitivity, specificity, positive predictive value, and diagnostic accuracy of 95.65%, 94.23%, 95.65%, and 95.04%, respectively, for determining the etiology. The threshold values for baseline bilirubin at 10 mg%, CA 19.9 at 225 u/L, and largest CBD diameter at 16 mm had specificities of 98%, 95%, and 92.5%, respectively, for a positive EUS diagnosis.

They found that EUC was highly accurate in diagnosing enlarged bile ducts when other imaging tests were inconclusive.

Source: bmcgastroenterol.biomedcentral.com/articles/10.1186/s12876-024-03406-5