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

File Download Links for fulltext
(May Require Subscription)
Supplementary
  • Basic View
  • Metadata View
  • XML View
TitleComparison of EUS and ERCP in the investigation with suspected biliary obstruction caused by choledocholithiasis: a randomized study
AuthorsLee, YT1
Chan, FKL1
Leung, WK1
Chan, HLY1
Wu, JCY1
Yung, MY1
Ng, EKW1
Lau, JYW1
Sung, JJY1
Issue Date2008
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gie
CitationGastrointestinal Endoscopy, 2008, v. 67 n. 4, p. 660-668 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.gie.2007.07.025
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.
ISSN0016-5107
2011 Impact Factor: 4.878
2011 SCImago Journal Rankings: 0.287
DOIhttp://dx.doi.org/10.1016/j.gie.2007.07.025
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorLee, YT
dc.contributor.authorChan, FKL
dc.contributor.authorLeung, WK
dc.contributor.authorChan, HLY
dc.contributor.authorWu, JCY
dc.contributor.authorYung, MY
dc.contributor.authorNg, EKW
dc.contributor.authorLau, JYW
dc.contributor.authorSung, JJY
dc.date.accessioned2012-09-05T05:28:12Z
dc.date.available2012-09-05T05:28:12Z
dc.date.issued2008
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.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationGastrointestinal Endoscopy, 2008, v. 67 n. 4, p. 660-668 [How to Cite?]
DOI: http://dx.doi.org/10.1016/j.gie.2007.07.025
dc.identifier.doihttp://dx.doi.org/10.1016/j.gie.2007.07.025
dc.identifier.epage668
dc.identifier.issn0016-5107
2011 Impact Factor: 4.878
2011 SCImago Journal Rankings: 0.287
dc.identifier.issue4
dc.identifier.pmid18155205
dc.identifier.scopuseid_2-s2.0-40949100455
dc.identifier.spage660
dc.identifier.urihttp://hdl.handle.net/10722/163151
dc.identifier.volume67
dc.languageeng
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/gie
dc.publisher.placeUnited States
dc.relation.ispartofGastrointestinal Endoscopy
dc.relation.referencesReferences in Scopus
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 And Over
dc.subject.meshCholangiopancreatography, Endoscopic Retrograde - Methods
dc.subject.meshCholedocholithiasis - Complications - Diagnosis
dc.subject.meshCholestasis, Extrahepatic - Diagnosis - Etiology
dc.subject.meshCommon Bile Duct
dc.subject.meshDiagnosis, Differential
dc.subject.meshEndosonography - Methods
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshHumans
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshReproducibility Of Results
dc.subject.meshRetrospective Studies
dc.titleComparison of EUS and ERCP in the investigation with suspected biliary obstruction caused by choledocholithiasis: a randomized study
dc.typeArticle
Author Affiliations
  1. Prince of Wales Hospital Hong Kong