[Endoscopic ultrasonography in the diagnosis of unexplained extrahepatic cholestasis]

The aim of this prospective study was to assess the diagnostic value of EUS for extrahepatic cholestasis unexplained before by US, ERCP and CT. Between 1994-1997 we examined 50 patients (24 women and 26 men, age range 21 to 72 years, mean age 53.2 years) with clinical and biochemical parameters of cholestasis, using the ultrasound endoscope with a 7.5 MHz linear electronic array transducer (Pentax FG-32UA/Hitachi 405EUB console). In one patient EUS was normal. In other 19 patients the causes of cholestasis were neoplasms, in 22 patients--inflammatory diseases and in 8 patients--choledocholithiasis. In majority of patients with chronic calcifying pancreatitis anicteric cholestasis was observed. 20 patients were operated on. Endo-sonographic diagnosis was confirmed in all patients with neoplasm of Vater papilla and pancreas, chronic calcifying pancreatitis and pancreatic abscess. Choledocholithiasis were confirmed by endoscopic sphincterotomy in all but one patient, endoscopic biliary drainages were performed in 9 patients. In 4 cases the diagnosis was false, mainly in patients with pseudotumorous pancreatitis. No complications during EUS were observed. EUS is efficacious and safe method in the diagnostics of extrahepatic cholestasis. In some cases it can replace diagnostic ERCP.