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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2017.1
- 수록면
- 290 - 297 (8page)
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초록· 키워드
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Background/Aims: When computed tomography (CT) does not indicate choledocholithiasis in highly suspicious patients, there is no definite consensus on the subsequent modality.
Endoscopic ultrasonography (EUS) indicates fewer procedurerelated complications than endoscopic retrograde cholangiopancreatography (ERCP) and has a lower cost than magnetic resonance cholangiopancreatography. Therefore, we aimed to investigate the diagnostic value of EUS in patients with suspected choledocholithiasis and negative CT findings.
Methods: Between March 2008 and November 2014, we retrospectively evaluated 200 patients with negative CT findings and high or intermediate probabilities of choledocholithiasis.
All patients initially underwent EUS followed by ERCP as a confirmatory criterion standard. The primary outcome in these patients was the accuracy of EUS in the detection of choledocholithiasis. The secondary outcome was the clinical prediction of common bile duct (CBD) stones in this group.
Results: EUS indicated choledocholithiasis in 165 of the 200 patients, and ERCP confirmed choledocholithiasis in 161 patients (80.5%). The accuracy of EUS in the detection of choledocholithiasis was 94.0% (sensitivity, 97.5%; specificity, 79.5%; positive predictive value, 95.2%; negative predictive value, 88.6%). A multivariate analysis demonstrated that choledocholithiasis was strongly predicted by EUS detection of choledocholithiasis, an age >55 years and a clinical diagnosis of cholangitis. Conclusions: An EUS-first approach is recommended for patients with suspected CBD stones and negative CT findings.
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참고문헌 (20)
참고문헌 신청
ASGE Standards of Practice Committee / 2010 / The role of endoscopy in the evaluation of suspected choledocholithiasis / Gastrointest Endosc 71 : 1 ~ 9
Ainsworth AP / 2003 / Is there a difference in diagnostic accuracy and clinical impact between endoscopic ultrasonography and magnetic resonance cholangiopancreatography / E
Anderson SW / 2006 / Accuracy of MDCT in the diagnosis of choledocholithiasis / AJR Am J Roentgenol 187 : 174 ~ 180
Bang BW / 2012 / Is endoscopic ultrasound needed as an add-on test for gallstone diseases without choledocholithiasis on multidetector computed tomography / Dig Dis Sci 57 :
Banks PA / 2013 / Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus / Gut 62 : 102 ~ 111
Ainsworth AP / 2003 / Is there a difference in diagnostic accuracy and clinical impact between endoscopic ultrasonography and magnetic resonance cholangiopancreatography / E
Anderson SW / 2006 / Accuracy of MDCT in the diagnosis of choledocholithiasis / AJR Am J Roentgenol 187 : 174 ~ 180
Bang BW / 2012 / Is endoscopic ultrasound needed as an add-on test for gallstone diseases without choledocholithiasis on multidetector computed tomography / Dig Dis Sci 57 :
Banks PA / 2013 / Classification of acute pancreatitis--2012: revision of the Atlanta classification and definitions by international consensus / Gut 62 : 102 ~ 111
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