Document Detail


Preoperative diagnosis of bile duct strictures--comparison of intraductal ultrasonography with conventional endosonography.
MedLine Citation:
PMID:  10672839     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The accuracy of intraductal ultrasonography (IDUS) and endoscopic ultrasonography (EUS) were compared in diagnosing biliary obstruction and in predicting surgical resectability. METHODS: Fifty-six patients with biliary obstruction were investigated preoperatively with both conventional EUS and IDUS. The ultrasonographic miniprobe was inserted into the bile duct system through the working channel of the duodenoscope during endoscopic retrograde cholangiopancreatography (ERCP). Conventional endosonography was performed with echoendoscopes in a standard technique. Images of endoluminal ultrasonography were prospectively reviewed and compared with intraoperative findings and resection specimen analyses. RESULTS: IDUS exceeded EUS in terms of accuracy (IDUS, 89.1%; EUS, 75.6%; P < 0.002), sensitivity (IDUS, 91.1%; EUS, 75.7%; P < 0.002), specificity (IDUS, 80%; EUS, 75%; NS), and T-staging (IDUS, 77.7%; EUS, 54.1%; P < 0.001). In bile duct carcinomas the accuracy rate for lymph node staging using IDUS (60%) is comparable with that using EUS (62.5%). In pancreatic carcinomas, however, lymph node staging using IDUS (13.3%) is significantly (P < 0.002) inferior to EUS (69.2%). Endoluminal ultrasonography may predict the potential resectability of bile duct tumors (IDUS, 81.8%; EUS, 75.6%; P < 0.002). CONCLUSIONS: IDUS proved to be accurate in preoperative diagnosing and T-staging of malignant biliary strictures, whereas it is not suitable for lymph node staging. IDUS using miniprobes during ERCP exceeds conventional EUS in terms of depiction of bile duct obstruction, diagnostic accuracy, and sensitivity and in the prediction of surgical tumor resectability. Additionally, different to EUS, IDUS can conveniently be performed during ERCP in one and the same session.
Authors:
J Menzel; C Poremba; K H Dietl; W Domschke
Related Documents :
16718819 - Mrcp and mri findings in 9 patients with autoimmune pancreatitis.
15688109 - Bile duct leaks after laparoscopic cholecystectomy: value of contrast-enhanced mrcp.
18434759 - Predictors of vascular and gastrointestinal complications in severe acute pancreatitis.
17680299 - Intraductal papillary mucinous neoplasms of the pancreas: correlation of helical ct and...
10888049 - Mr sialographic evaluation of sialectasia of stensen's duct: comparison with x-ray sial...
11222199 - Tissue harmonic imaging: is it a benefit for bile duct sonography?
10587129 - Comparison of unenhanced, hepatic arterial-dominant, and portal venous-dominant phase h...
20479649 - Intravascular functional maps of common neurovascular lesions derived from volumetric 4...
11930049 - Transient hypoxia-ischemia in rats: changes in diffusion-sensitive mr imaging findings,...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Scandinavian journal of gastroenterology     Volume:  35     ISSN:  0036-5521     ISO Abbreviation:  Scand. J. Gastroenterol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-03-01     Completed Date:  2000-03-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0060105     Medline TA:  Scand J Gastroenterol     Country:  NORWAY    
Other Details:
Languages:  eng     Pagination:  77-82     Citation Subset:  IM    
Affiliation:
Dept. of Medicine B, University of Münster, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Bile Duct Neoplasms / complications,  surgery,  ultrasonography
Bile Ducts / ultrasonography*
Cholangiopancreatography, Endoscopic Retrograde
Cholestasis / etiology,  radiography,  surgery,  ultrasonography*
Constriction, Pathologic / ultrasonography
Diagnosis, Differential
Endosonography*
Female
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Sensitivity and Specificity

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Abdominal symptoms: do they predict gallstones? A systematic review.
Next Document:  Diet restriction increases ubiquinone contents and inhibits progression of hepatocellular carcinoma ...