The Role of EUS In Patients With Suspected CBD Stone. A Single Centre Experience

Aims Endoscopic retrograde cholangiopancreatography (ERCP) has been standard procedure for removal of bile duct stones. In a small but clinically significant proportion of patients with suspected choledocholithiasis ERCP is negative.

To determine the rate of negative ERCP for suspected CBD stone on MRCP and role of EUS in preventing unnecessary ERCP [1].

Methods A retrospective review was performed from January to June, 2024 to identify patients with suspected common bile duct stones on MRCP. The analysis was split into patients with suspected stones on MRCP either undergoing directly for ERCP or having EUS prior to ERCP.

Results A total of 324 ERCPs were performed during this time period, (50.6% male, 49.4% females). The mean age was 67.4 years (± 16.5). 219 patients were referred for ERCP for CBD stone, of which 186 had confirmed stones on MRCP while 33 patients had suspected stones. 19/33 underwent directly for ERCP, of which 42% ERCP were negative for CBD stones (8/19). While 14/33 patients had EUS prior to ERCP which confirmed stones only in 2 patients thus EUS had saved 12/14 (86%) patient from having negative ERCP. Out of 186 patients with definite CBD stones on MRCP, 18 patients (9.6%) had negative ERCP.

Conclusions A pre-procedure EUS can significantly prevent unnecessary ERCP in patients with suspected CBD stones.

Publikationsverlauf

Artikel online veröffentlicht:
27. März 2025

• References

• 1 Suspected common bile duct stones: reduction of unnecessary ERCP by pre-procedural imaging and timing of ERCP. Surg Endosc 2023; 37: 1194-1202