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Article: Comparison of EUS and ERCP in the investigation with suspected biliary obstruction caused by choledocholithiasis: a randomized study

TitleComparison of EUS and ERCP in the investigation with suspected biliary obstruction caused by choledocholithiasis: a randomized study
Authors
Issue Date2008
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gie
Citation
Gastrointestinal Endoscopy, 2008, v. 67 n. 4, p. 660-668 How to Cite?
AbstractBackground: EUS may be used to reduce the need of diagnostic ERCP. Objective: Our purpose was to investigate the benefits and safety of an EUS-guided versus an ERCP-guided approach in the management of suspected biliary obstructive diseases caused by choledocholithiasis, in whom a US study is not diagnostic. Design: A randomized study. Setting: A university medical unit. Patients: Patients with clinical, biochemical, or radiologic suspicion of biliary obstruction. Interventions: In the EUS group, therapeutic ERCP was performed at the same EUS session if a lesion was found. In the ERCP group, therapeutic treatment was carried out at the discretion of the endoscopist. Main Outcome Measurements: The number of ERCPs avoided, procedure-related complications, and recurrent biliary symptoms on follow-up at 1 year. Results: Thirty-three patients were randomized to EUS and 32 to ERCP. Three patients (9.4%) had failed ERCPs, whereas all EUS procedures were successful. Nine (27.3%) patients in the EUS group were found to have biliary lesions that were all treated by ERCP. In the ERCP group, 7 (22%) patients had biliary lesions detected that were treated in the same session. More patients had serious complications (bleeding, acute pancreatitis, and umbilical abscess) in the ERCP group. One patient in each group had recurrent biliary symptoms during follow-up. With EUS used as a triage tool, diagnostic ERCP and its related complications could be spared in 49 (75.4%) patients. Conclusions: In patients suspected to have biliary obstructive disease, EUS is a safe and accurate test to select patients for therapeutic ERCP. © 2008 American Society for Gastrointestinal Endoscopy.
Persistent Identifierhttp://hdl.handle.net/10722/163151
ISSN
2015 Impact Factor: 6.217
2015 SCImago Journal Rankings: 2.390
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLee, YTen_US
dc.contributor.authorChan, FKLen_US
dc.contributor.authorLeung, WKen_US
dc.contributor.authorChan, HLYen_US
dc.contributor.authorWu, JCYen_US
dc.contributor.authorYung, MYen_US
dc.contributor.authorNg, EKWen_US
dc.contributor.authorLau, JYWen_US
dc.contributor.authorSung, JJYen_US
dc.date.accessioned2012-09-05T05:28:12Z-
dc.date.available2012-09-05T05:28:12Z-
dc.date.issued2008en_US
dc.identifier.citationGastrointestinal Endoscopy, 2008, v. 67 n. 4, p. 660-668en_US
dc.identifier.issn0016-5107en_US
dc.identifier.urihttp://hdl.handle.net/10722/163151-
dc.description.abstractBackground: EUS may be used to reduce the need of diagnostic ERCP. Objective: Our purpose was to investigate the benefits and safety of an EUS-guided versus an ERCP-guided approach in the management of suspected biliary obstructive diseases caused by choledocholithiasis, in whom a US study is not diagnostic. Design: A randomized study. Setting: A university medical unit. Patients: Patients with clinical, biochemical, or radiologic suspicion of biliary obstruction. Interventions: In the EUS group, therapeutic ERCP was performed at the same EUS session if a lesion was found. In the ERCP group, therapeutic treatment was carried out at the discretion of the endoscopist. Main Outcome Measurements: The number of ERCPs avoided, procedure-related complications, and recurrent biliary symptoms on follow-up at 1 year. Results: Thirty-three patients were randomized to EUS and 32 to ERCP. Three patients (9.4%) had failed ERCPs, whereas all EUS procedures were successful. Nine (27.3%) patients in the EUS group were found to have biliary lesions that were all treated by ERCP. In the ERCP group, 7 (22%) patients had biliary lesions detected that were treated in the same session. More patients had serious complications (bleeding, acute pancreatitis, and umbilical abscess) in the ERCP group. One patient in each group had recurrent biliary symptoms during follow-up. With EUS used as a triage tool, diagnostic ERCP and its related complications could be spared in 49 (75.4%) patients. Conclusions: In patients suspected to have biliary obstructive disease, EUS is a safe and accurate test to select patients for therapeutic ERCP. © 2008 American Society for Gastrointestinal Endoscopy.en_US
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gieen_US
dc.relation.ispartofGastrointestinal Endoscopyen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshCholangiopancreatography, Endoscopic Retrograde - Methodsen_US
dc.subject.meshCholedocholithiasis - Complications - Diagnosisen_US
dc.subject.meshCholestasis, Extrahepatic - Diagnosis - Etiologyen_US
dc.subject.meshCommon Bile Ducten_US
dc.subject.meshDiagnosis, Differentialen_US
dc.subject.meshEndosonography - Methodsen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshReproducibility Of Resultsen_US
dc.subject.meshRetrospective Studiesen_US
dc.titleComparison of EUS and ERCP in the investigation with suspected biliary obstruction caused by choledocholithiasis: a randomized studyen_US
dc.typeArticleen_US
dc.identifier.emailLeung, WK:waikleung@hku.hken_US
dc.identifier.authorityLeung, WK=rp01479en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1016/j.gie.2007.07.025en_US
dc.identifier.pmid18155205-
dc.identifier.scopuseid_2-s2.0-40949100455en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-40949100455&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume67en_US
dc.identifier.issue4en_US
dc.identifier.spage660en_US
dc.identifier.epage668en_US
dc.identifier.isiWOS:000254596300014-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLee, YT=8041471500en_US
dc.identifier.scopusauthoridChan, FKL=7202586434en_US
dc.identifier.scopusauthoridLeung, WK=7201504523en_US
dc.identifier.scopusauthoridChan, HLY=16038785900en_US
dc.identifier.scopusauthoridWu, JCY=8041471100en_US
dc.identifier.scopusauthoridYung, MY=7101896866en_US
dc.identifier.scopusauthoridNg, EKW=7201647539en_US
dc.identifier.scopusauthoridLau, JYW=13907867100en_US
dc.identifier.scopusauthoridSung, JJY=35405352400en_US

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