Endoscopic ultrasound accurately detects bile duct stones

Last Updated: 2017-07-05

By Reuters Staff

NEW YORK (Reuters Health) - Endoscopic ultrasound (EUS) is somewhat more accurate than magnetic resonance cholangiopancreatography (MRCP) for diagnosing choledocholithiasis, researchers from Canada report.

EUS and MRCP are more accurate than clinical assessment and abdominal ultrasound for diagnosing suspected choledocholithiasis, but it is unclear whether one outperforms the other in terms of diagnostic accuracy.

Dr. Mohammad Yaghoobi and colleagues from McMaster University, Hamilton, Ontario, compared the diagnostic accuracy, sensitivity, and specificity of EUS and MRCP in diagnosing choledocholithiasis in their meta-analysis of five head-to-head prospective studies involving a total of 272 patients.

The overall diagnostic accuracy of EUS was significantly higher than that of MRCP, mainly due to significantly higher sensitivity of EUS (97%) compared with MRCP (87%), according to the June 20th Gastrointestinal Endoscopy online report.

Specificity was similar for EUS (90%) and MRCP (92%).

The two techniques did not differ in Youden’s index, a general index of test accuracy that uses a combination of sensitivity and specificity.

"Both EUS and MRCP are operative-dependent and the interpretation of findings and subjective bias," the researchers note. "However, the observed superiority in the sensitivity of EUS as compared with MRCP might be due to better accuracy of EUS in detection of small stones."

“EUS should be incorporated in the diagnostic algorithm in patients suspected for choledocholithiasis, whenever appropriate, given its reasonable safety profile,” they conclude. “This might specially apply to the patients who need an esophagogastroduodenoscopy for investigating other alternative causes of abdominal pain. Future head-to-head studies should focus on the size or clinical significance of the choledocholithiasis identified by each modality.”

Dr. Yaghoobi did not respond to a request for comments.

SOURCE: http://bit.ly/2tD6dbS

Gastrointest Endosc 2017.