THE CONTRIBUTION OF ENDOSCOPIC ULTRASONOGRAPHY IN BILIARY DUCT DILATATION WITHOUT VISIBLE IMAGING OBSTRUCTION

Aims Endoscopic ultrasonography (EUS) is an effective and primordial procedure for exploring the biliopancreatic junction abnormalities. However, its results depend of the operator expertise, and its availability is currently insufficient in our regions.

The aim of this study is to determine the role of endoscopic ultrasonography in assessment of etiological diagnosis of bile ducts dilatation when conventional imaging is inconclusive.

Methods This is a retrospective descriptive study conducted from January 2008 to May 2021, including 51 patients with intra-and/or extra-hepatic bile duct dilatation without visible obstacle on imaging. TODANI classification was considered for common bile duct (CBD) cystic dilatations.

Results We enrolled 51 patients responding to inclusion criteria, which represented 11% of all indications of EUS. The mean age of our patients was 60±12,10 years, with a female predominance.

EUS showed a dilated CBD in 56,9% of cases with a double duct sign in 5,9% of cases. The main diagnoses revealed were a cystic dilatation of CBD in 43,1%, predominated by type Ia and Ib in 38,1% and 4% respectively, a choledocholithiasis in 5.9% of the cases, an ampulloma in 3,9% of cases, and papillomatosis of the bile ducts in 2% of cases. The pancreatic head cancer was suspected during echo-endoscopy and then confirmed histologically in 2% of patients. However, echo-endoscopy allowed us to exclude biliary ducts dilatation in 43.1% of our patients.

Conclusions Our study confirms the prominent place of EUS in etiological profile of bile ducts dilatations when imaging is inconclusive.

Publication History

Article published online:
14 April 2022