Endoscopic ultrasound in patients with normal liver blood tests and unexplained dilatation of common bile duct and or pancreatic duct. (April 2014)

• Record Type: Journal Article
• Authors: Oppong, Kofi W.; Mitra, Vikramjit; Scott, John; Anderson, Kirsty; Charnley, Richard M.; Bonnington, Stuart; Jaques, Bryon; White, Steven; French, Jeremy J.; Manas, Derek M.; Sen, Gourab; Nayar, Manu K.
• Is Part Of: Scandinavian journal of gastroenterology. Volume 49:Number 4(2014)
• Page Start: 473
• Page End: 480
• Publication Date: 2014-04
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.3109/00365521.2014.881547
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Objective.</italic> </bold> To determine the yield of endoscopic ultrasound (EUS) in the investigation of patients with normal liver function tests (LFTs) and unexplained dilatation of common bile duct (CBD) and/or pancreatic duct (PD), following CT and/or magnetic resonance cholangiopancreatography. <bold><italic>Materials and methods.</italic></bold> Consecutive patients undergoing linear EUS between January 2007 and August 2011 for the indication of dilated CBD and/or PD, normal LFT, and nondiagnostic cross-sectional imaging formed the study group. The study was performed as a retrospective analysis of prospectively collected data. <bold><italic>Results.</italic></bold> During the study period, 83 patients (CBD and PD dilatation <italic>n</italic> = 38, PD dilatation <italic>n</italic> = 5, CBD dilatation <italic>n</italic> = 40) met the inclusion criteria and underwent EUS. Five (13.1%) of the CBD and PD groups had a new finding, which in one (2.6%) case was causal. In this group, men were significantly more likely to have a new finding (<italic>p</italic> = 0.012). Eight (20%) of the CBD group had a new finding, which in seven (17.5%) cases was causal. In the CBD group, cholecystectomy was significantly (<italic>p</italic> = 0.005) more common in those without a finding. Three (60%) of the PD group had a finding on EUS, all of which were causal, including a case of pancreatic malignancy. <bold><italic>Conclusion.</italic></bold> There is a significant yield from EUS in individuals with isolated PD dilatation and isolated CBD dilatation. Previous cholecystectomy is significantly associated with a negative EUS in the group with isolated CBD dilatation. The yield in those with CBD and PD dilatation was low and a finding was more likely in males.</p> </abstract>