Endoscopic Ultrasonography for Diagnosing Common Bile Duct Stones With Negative Initial Imaging: A Multicenter...

Area of Science:

• Gastroenterology
• Diagnostic Imaging

Background:

• Common bile duct stones (CBDSs) pose significant health risks.
• Endoscopic retrograde cholangiopancreatography (ERCP) is a common treatment but carries high adverse event rates.
• Accurate diagnosis is crucial, even in high-suspicion cases where initial imaging is negative.

Purpose of the Study:

• To evaluate the diagnostic utility of endoscopic ultrasonography (EUS) for common bile duct stones (CBDSs).
• To assess EUS performance in patients with a high likelihood of CBDSs but negative initial imaging.

Main Methods:

• A multicenter prospective study included patients with high-likelihood CBDSs based on American Society of Gastrointestinal Endoscopy guidelines.
• Patients underwent EUS after negative initial imaging.
• Diagnostic performance was determined by comparing EUS findings with ERCP results or clinical outcomes.

Main Results:

• EUS identified CBDSs in 21 of 48 analyzed patients.
• EUS demonstrated high diagnostic accuracy (95.8%), sensitivity (100%), and specificity (93.1%).
• In patients ultimately diagnosed without CBDSs, EUS helped avoid unnecessary ERCP in 79.3%.

Conclusions:

• Endoscopic ultrasonography (EUS) is an accurate tool for diagnosing common bile duct stones (CBDSs) in patients with strong clinical suspicion and negative initial imaging.
• EUS can help reduce the rate of unnecessary endoscopic retrograde cholangiopancreatography (ERCP) procedures.