Heinzow HS, Kammerer S, Rammes C, Wessling J, Domagk D, Meister T. Comparative analysis of ERCP, IDUS, EUS and CT in predicting malignant bile duct strictures. World J Gastroenterol 2014; 20(30): 10495-10503 [PMID: 25132767 DOI: 10.3748/wjg.v20.i30.10495]
Corresponding Author of This Article
Tobias Meister, MD, Department of Medicine II, HELIOS Albert-Schweitzer Hospital, Göttingen University Teaching Hospital, Sturmbäume 8-10, D-37154 Northeim, Germany. tobiasmeister@gmx.de
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
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World J Gastroenterol. Aug 14, 2014; 20(30): 10495-10503 Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10495
Comparative analysis of ERCP, IDUS, EUS and CT in predicting malignant bile duct strictures
Hauke S Heinzow, Sara Kammerer, Carina Rammes, Johannes Wessling, Dirk Domagk, Tobias Meister
Hauke S Heinzow, Carina Rammes, Dirk Domagk, Department of Medicine B, University of Münster, D-48149 Münster, Germany
Sara Kammerer, Department of Clinical Radiology, University of Münster, D-48149 Münster, Germany
Johannes Wessling, Department of Radiology, Clemenshospital, Münster University Teaching Hospital, D-48153 Münster, Germany
Tobias Meister, Department of Medicine II, HELIOS Albert-Schweitzer Hospital, Göttingen University Teaching Hospital, D-37154 Northeim, Germany
Author contributions: Heinzow HS and Kammerer S equally contributed to this work; Heinzow HS contributed to the design of the study, analysis and interpretation of data, drafting of the manuscript, analysis and interpretation of data, technical and material support; Kammerer S contributed to drafting of the manuscript, analysis and interpretation of data, technical and material support; diagnostics of computed tomography; Rammes C contributed to acquisition of data and drafting of the manuscript; Wessling J contributed to critical revision of the manuscript for important intellectual content, interpretation of radiological imaging; Domagk D contributed to critical revision of the manuscript for important intellectual content; Meister T contributed to study concept and design, performance of the IDUS procedures, analysis and interpretation of data, drafting of the manuscript, statistical analysis, study supervision, final approval of the version to be published.
Correspondence to: Tobias Meister, MD, Department of Medicine II, HELIOS Albert-Schweitzer Hospital, Göttingen University Teaching Hospital, Sturmbäume 8-10, D-37154 Northeim, Germany. tobiasmeister@gmx.de
Telephone: +49-5551-971244 Fax: +49-5551-971240
Received: February 9, 2014 Revised: March 29, 2014 Accepted: May 12, 2014 Published online: August 14, 2014 Processing time: 189 Days and 17.8 Hours
Core Tip
Core tip: A cohort of 234 patients with bile duct strictures of unknown etiology was examined to determine the diagnostic efficiency of endoscopic retrograde cholangio-pancreatography (ERCP), intraductal ultrasound (IDUS), endosonography (EUS), endoscopic transpapillary forceps biopsies (ETP) and computed tomography (CT). The detection rate of malignancy by ERCP/IDUS was superior to ETP (91% vs 59%, P < 0.0001), EUS (91% vs 74%, P < 0.0001), and CT (91% vs 73%, P < 0.0001); EUS was comparable to CT (74% vs 73%, P = 0.649). Taking the findings of our study into account, we suggest that ERCP/IDUS is superior to EUS and CT in providing accurate diagnoses of bile duct strictures of uncertain etiology, thus allowing for adequate further clinical management.
