Published online Sep 16, 2022. doi: 10.4253/wjge.v14.i9.564
Peer-review started: June 2, 2022
First decision: July 12, 2022
Revised: July 26, 2022
Accepted: September 6, 2022
Article in press: September 6, 2022
Published online: September 16, 2022
Choledocholithiasis develops in up to 20% of patients with gall bladder stones. The challenge in diagnosis usually occurs with small stones that may be missed by magnetic resonance cholangiopancreatography (MRCP). Endoscopic ultr
To evaluate the accuracy of EUS in detecting CBD stones missed by MRCP.
Patients with an intermediate likelihood of choledocholithiasis according to ESGE guidelines and those with acute pancreatitis of undetermined cause were incl
Ninety out of 100 involved patients had choledocholithiasis, while ten patients were excluded as they had pancreatic or gall bladder masses during EUS exam
EUS could be a useful tool in assessing patients with suspected choledocholithiasis especially if combined with MRCP. However, its usefulness depends on its availability and the experience of the local centers.
Core Tip: Still, there is a great challenge in diagnosing suspected cases of choledocholithiasis that could develop in up to 20% of patients with gall bladder stones. Endoscopic ultrasound (EUS) can easily detect small stones that magnetic resonance cholangiopancreatography (MRCP) could miss. EUS still has many diagnostic purposes with high accuracy in detecting common bile duct (CBD) stones missed by MRCP, especially the small ones or those impacted at the distal CBD or the papillary region.