Original ArticlesEvaluation of indeterminate bile duct strictures by intraductal US☆
Section snippets
Patients and methods
A retrospective chart review of all ERCP procedures performed between September 1999 and November 2000 identified 30 patients suspected to have a bile duct stricture of indeterminate nature based on US and CT (etiology unknown after both imaging studies with no definite mass identified by either) who underwent ERCP and IDUS. This comprised all patients who underwent both ERCP and IDUS during the study period. The study was approved by our institutional review board. All patients provided
Results
Thirty consecutive patients undergoing combined ERCP and IDUS were included. Patient demographics (age, gender, history of previous surgery) as well as the length, thickness, and location of the bile duct stricture are shown in Table 1.
No. of patients 30 Age (y), mean (SD) 63 (17) (range 16-84) Gender (M:F) 21:9 Previous cholecystectomy 7 Length of stricture (mm), mean (SD) 17 (6) (range 12-20) Thickness of stricture (mm), mean (SD) 4 (2) (range 0.6-12) Location of stricture CBD 11
Discussion
The sensitivity, specificity, and accuracy of ERCP (respectively, 86%, 47%, and 73%), brush cytology (respectively, 54%, 100%, and 68%), and forceps biopsy (respectively, 53%, 100%, and 67%) in the evaluation of bile duct strictures are less than optimal.4, 5, 6 Whether IDUS improves these results has not been evaluated to date. The results of the present study suggest that IDUS provides additional information beyond that which can be obtained by ERCP, tissue sampling, or both. The overall
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Reprint requests: Maurits J. Wiersema MD, 200 First St. SW, Mayo Clinic, Eisenberg 8A, Rochester, MN 55905.