| Preoperative diagnosis of bile duct strictures--comparison of intraductal ultrasonography with conventional endosonography. | |
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MedLine Citation:
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PMID: 10672839 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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J Menzel; C Poremba; K H Dietl; W Domschke |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Scandinavian journal of gastroenterology Volume: 35 ISSN: 0036-5521 ISO Abbreviation: Scand. J. Gastroenterol. Publication Date: 2000 Jan |
Date Detail:
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Created Date: 2000-03-01 Completed Date: 2000-03-01 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0060105 Medline TA: Scand J Gastroenterol Country: NORWAY |
Other Details:
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Languages: eng Pagination: 77-82 Citation Subset: IM |
Affiliation:
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Dept. of Medicine B, University of Münster, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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 |
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