Diagnostic efficacy of echography in cholestasis

The usefulness of hepatobiliary echography was assessed prospectively in 32 patients with cholestatic jaundice. The predictive reliability of the method for detecting major bile duct obstruction was 93% and for excluding this possibility was 88%. Echography altered diagnostic thinking significantly in 22 patients (69%). Correct management decisions were made promptly in all but 1 patient who underwent unnecessary laparotomy for acute hepatitis. Laparotomy was correctly avoided in 2 patients and invasive investigations were not required in a further 12. It is concluded that hepatobiliary echography is a useful and cost-effective method in the diagnosis and management of the jaundiced patient.