The contribution of echo-endoscopy in cases of biliary tract dilation without detectable obstruction on imaging

Aims Echoendoscopy is an indispensable technique for exploring anomalies of the bilio-pancreatic junction. However, it raises problems of availability and operator expertise. The aim of our study is to determine the role of echo-endoscopy in the etiological diagnosis of biliary tract dilatations when conventional imaging is inconclusive.

Methods This is a retrospective descriptive and analytical study conducted between January 2011 and March 2024, including 51 patients with intra- and/or extra-hepatic bile duct dilatation on imaging without visible obstruction. For cystic dilatations of the main bile duct, the TODANI classification was taken into consideration. Statistical analysis was performed using Jamovi 2.4 software.

Results A total of 51 patients were enrolled, representing approximately 11% of all indications for echo-endoscopy in our department. The mean age of our patients was 60±12.10 years, with extremes ranging from 28 to 80 years. Our series was characterized by a clear female predominance (78%), i.e. a sex ratio M/F: 0.28. Echoendoscopy confirmed dilatation in 56.9% (n=29) of our patients, and bi-canal dilatation was found in 5.9% (n=3) of patients.Echoendoscopy revealed type I cystic biliary dilatation according to the TODANI classification in 43.1% (n=22) of cases, VBP lithiasis in 5.9% (n=3) and ampulloma in 3.9% (n=2), cancer of the head of the pancreas was suspected during echo-endoscopy and histologically confirmed in 2% of patients (n=1), and biliary papillomatosis was diagnosed in 2% of patients (n=1). Nevertheless, echo-endoscopy enabled us to rule out biliary dilatation in 43.1% (n=22) of our patients.

Conclusions Our study has shown that echo-endoscopy plays a vital role in the diagnosis of biliary dilatation when imaging is inconclusive.

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Artikel online veröffentlicht:
27. März 2025