Unit of Gastroenterology, Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid, Spain.
Rev Esp Enferm Dig. 2011 Jul;103(7):345-8. doi: 10.4321/s1130-01082011000700002.
endoscopic ultrasound (EUS) is a very sensitive and specific technique for the diagnosis of biliary diseases. This procedure has proven its usefulness in cases of high suspicion of biliary disease (history of gallstones and dilatation of the intrahepatic and/or extrahepatic bile ducts). We know less about its usefulness in cases of low suspicion of biliary pathology.The aim of this study was to assess the diagnostic accuracy of EUS in patients with low suspicion of biliary disease (patients with dilatation of the biliary tract were excluded).
33 patients with low suspicion of biliary disease were recruited in 12 months. All of them had no biliary findings in a previous abdominal ultrasound and computer tomography scan. All of them underwent EUS and were studied prospectively. The diagnosis was confirmed by surgery and/or by ERCP in patients with positive EUS or clinical follow-up in those with normal EUS. Time of follow-up was 9 months (range, 3-12 months).
seventeen patients (51.5%) presented with abnormal biliary findings on EUS (7 choledocholithiasis, 3 cholelithiasis, 2 choledocholithiasis + cholelithiasis and 5 microlithiasis).
EUS is a useful and safe procedure for diagnosing patients with low suspicion of biliary disease.
内镜超声（EUS）是一种非常敏感和特异的诊断胆道疾病的技术。该方法已被证实对高度怀疑胆道疾病的病例（有胆石症病史且肝内外胆管扩张）具有较高的诊断价值。但对于低度怀疑胆道疾病的病例，其应用价值我们了解得较少。本研究旨在评估内镜超声（EUS）在低度怀疑胆道疾病（排除胆道扩张的患者）患者中的诊断准确性。
12 个月内共招募了 33 例低度怀疑胆道疾病的患者。所有患者的腹部超声和计算机断层扫描（CT）检查均未见胆道异常。所有患者均接受了 EUS 检查，并进行前瞻性研究。对于 EUS 阳性的患者，通过手术和（或）经内镜逆行胰胆管造影（ERCP）确诊；EUS 正常的患者则进行临床随访。随访时间为 9 个月（3-12 个月）。
17 例患者（51.5%）EUS 检查发现胆道异常（7 例胆总管结石、3 例胆囊结石、2 例胆总管结石+胆囊结石、5 例微结石）。
EUS 是一种安全、有效的诊断低度怀疑胆道疾病患者的方法。
