Comparison of Radial Echoendoscopy and Predictive Factors in the Evaluation of Patients with Suspected Choledocholithiasis

Abstract

Objective: The aim of this study was to compare predictive factors and endoscopic ultrasound (EUS) in the diagnosis of choledocholithiasis. Materials and Methods: Patients with suspected choledocholithiasis were recruited from April 2011 to January 2018. All patient characteristics, EUS findings and ERCP findings were recorded and analyzed. Results: Eighty patients were enrolled in this study. Clinical symptoms, blood chemistry and liver function tests were similar in patients with and without choledocholithiasis. Using the findings of ERCP as the gold standard, radial EUS had a sensitivity and specificity for the detection of choledocholithiasis of 90.2% and 97.4%, and for choledocholithiasis and/or common bile duct sludge 92.7% and 100%, respectively. For patients with intermediate likelihood and high likelihood of having choledocholithiasis, as calculated from their predictive factors (33 and 45), radial EUS was positive for choledocholithiasis in 51.5% (17/33) and 46.7% (21/45), and ERCP was positive for choledocholithiasis in 54.5% (18/33) and 48.9% (22/45), respectively. Conclusion: Predictive factors, for both the intermediate and high likelihood groups, were not accurate to diagnose these patients. EUS is a good diagnostic tool and should be performed in both groups of patients to avoid unnecessary ERCP.