Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jan 21, 2012; 18(3): 275-278
Published online Jan 21, 2012. doi: 10.3748/wjg.v18.i3.275
Efficacy of intraductal ultrasonography in the diagnosis of non-opaque choledocholith
Jie Lu, Chuan-Yong Guo, Xuan-Fu Xu, Xing-Peng Wang, Rong Wan
Jie Lu, Chuan-Yong Guo, Xuan-Fu Xu, Xing-Peng Wang, Rong Wan, Department of Gastroenterology, Shanghai 10th People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
Author contributions: Wan R and Lu J contributed equally to this work; Wan R, Lu J, Guo CY, Xu XF and Wang XP designed the research; Wan R and Lu J performed the research; Xu XF and Guo CY performed the analysis of the data; Lu J and Wan R wrote the first draft of paper; all authors contributed to the interpretation of the study and to the modification of further drafts of the paper; Wan R is the guarantor.
Supported by Shanghai Natural Science Foundation, No. 08411962900
Correspondence to: Rong Wan, MD, PhD, Professor, Department of Gastroenterology, Shanghai 10th People’s Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai 200072, China. kennisren@hotmail.com
Telephone: +86-21-66301174 Fax: +86-21-66301174
Received: April 26, 2011
Revised: August 18, 2011
Accepted: August 27, 2011
Published online: January 21, 2012
Abstract

AIM: To evaluate the efficacy of intraductal ultrasonography (IDUS) in the diagnosis of non-opaque, common bile duct stones.

METHODS: A total of 183 patients (102 males, mean age 73 years; 81 females, mean age 70 years) with suspected common bile duct stones diagnosed through abdominal computed tomography (CT), magnetic resonance imaging (MRI), and abdominal Type-B ultrasound were included in the study. The diagnosis was confirmed through endoscopic retrograde cholangiopancreatography (ERCP) followed by IDUS.

RESULTS: A total of 183 patients with suspected common bile duct (CBD) stones were included in the study as follows: 36 patients with high-density CBD stones, 68 patients with sand-like stones, 44 patients with low-density stones, 21 patients with ampullary cancer, and 14 patients with pancreatic cancer. Conventional imaging revealed 124 cases of choledochectasia, and only 36 cases of suspected CBD stones; ERCP revealed 145 cases of CBD stones with three missed diagnoses. IDUS revealed 148 cases of CBD stones, 21 cases of ampullary tumors, and 14 cases of pancreatic cancer.

CONCLUSION: IDUS was more effective in the diagnosis of bile duct stones than ERCP, upper abdominal CT or upper abdominal MRI.

Keywords: Biliary intraductal ultrasonography, Endoscopic retrograde cholangiopancreatography, Common bile duct stones, Non-opaque stones, Sand-like stones