[Value of ultrasonography in the diagnosis of distal choledocolithiasis]

We performed real time echotomographic studies in 203 patients with a clinical diagnosis of obstructive jaundice. All patients were operated on and a diagnosis of choledocholithiasis was established in 125. The same diagnosis had been made by echo in 69 of them for a 63% sensitivity rate. The specificity was 92% and the positive predictive value 93%. An improvement in sensitivity from 52 to 80% and in specificity from 91 to 94% along the 3 year study period was detected. This high yield of the echographic study, not widespread in the literature, may be attributed to a careful study of the intrapancreatic section of the common duct were 92% of the stones were found. Also, the experience and training of the radiologist performing the examination is essential.