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Over-the-wire US catheter probe as an adjunct to ERCP in the detection of choledocholithiasis
- Source :
- Gastrointestinal Endoscopy. 54:720-723
- Publication Year :
- 2001
- Publisher :
- Elsevier BV, 2001.
-
Abstract
- Background: Intraductal ultrasound (IDUS) as an adjunct to ERCP for detection of extrahepatic bile duct stones is technically easy, accurate, and safe. This prospective study evaluated IDUS with an "over-the-wire" catheter US probe as an adjunct to ERCP. Methods: Sixty-five patients, highly suspected to have choledocholithiasis, underwent IDUS during ERCP. The IDUS probe was inserted by means of the duodenoscope into the bile duct without performing a sphincterotomy. All stones identified by IDUS or retrograde cholangiography were removed with either a basket or retrieval balloon after endoscopic sphincterotomy. Results: The final diagnosis was choledocholithiasis in 59 patients. Bile duct diameter ranged from 0.6 to 2.3 cm and stone size from 2 mm to 2 cm. IDUS successfully identified all stones in these patients. IDUS resulted in 2 false-positive diagnoses in the remaining 6 patients without stones (overall accuracy 97%, sensitivity 100%, specificity 67%). Cholangiography detected stones in 55 of the patients with stones (accuracy 94%, sensitivity 93%, specificity 100%). Conclusion: IDUS, a safe, technically easy procedure, is highly accurate in the detection of extrahepatic bile duct stones regardless of the diameter of the bile ducts. The "over-the-wire" technique preserves access to the cannulated duct. IDUS is an excellent adjunct to ERCP for the diagnosis of choledocholithiasis. IDUS differentiates stones from air bubbles and prevents unnecessary sphincterotomy. (Gastrointest Endosc 2001;54:720-3.)
- Subjects :
- Adult
Male
medicine.medical_specialty
Gallstones
Stone size
Balloon
Sensitivity and Specificity
Endosonography
Cholangiography
mental disorders
medicine
Humans
Radiology, Nuclear Medicine and imaging
Prospective Studies
Aged
Aged, 80 and over
Cholangiopancreatography, Endoscopic Retrograde
medicine.diagnostic_test
business.industry
Bile duct
Gastroenterology
Middle Aged
medicine.disease
Surgery
Endoscopy
Catheter
medicine.anatomical_structure
Intraductal ultrasound
Female
business
Subjects
Details
- ISSN :
- 00165107
- Volume :
- 54
- Database :
- OpenAIRE
- Journal :
- Gastrointestinal Endoscopy
- Accession number :
- edsair.doi.dedup.....08e969181e78d46bb62edaa2687923a6