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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 39 Issue 2
Feb.  2023
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Article Navigation >  Journal of Clinical Hepatology  > 2023  >  39(2): 370-375

Value of endoscopic ultrasonography in the diagnosis of muddy stones of the common bile duct

DOI: 10.3969/j.issn.1001-5256.2023.02.018
  • 1.

    Graduate School of Guilin Medical University, Guilin, Guangxi 541000, China

  • 2.

    Department of Gastroenterology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, Guangxi 541002, China

Research funding:

Guangxi Natural Science Foundation (2015GXNSFAA139222);

The Health Commission of Guangxi Zhuang Autonomous Region (Z20200686)

More Information
  • Corresponding author: ZHANG Qifang, zhangqifang-gl@163.com (ORCID: 0000-0001-6889-8847)
  • Received Date: 2022-07-25
  • Accepted Date: 2022-08-29
  • Published Date: 2023-02-20
    Abstract
  •   Objective  To investigate whether endoscopic ultrasonography (EUS) can be an alternative method for diagnostic endoscopic retrograde cholangiopancreatography (ERCP) by comparing the ability of EUS versus CT and transabdominal ultrasonography (TUS) in the diagnosis of muddy stones of the common bile duct.  Methods  A prospective study was conducted for 53 patients suspected of muddy stones of the common bile duct who attended Nanxishan Hospital of Guangxi Zhuang Autonomous Region from July 2019 to December 2021, and all patients underwent EUS, TUS, and CT before ERCP. With ERCP and endoscopic sphincterotomy (EST) for removing muddy stones of the common bile duct as the gold standard for the diagnosis of muddy stones of the common bile duct, EUS, TUS, and CT were compared in terms of their ability to display the muddy stones of the common bile duct. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups.  Results  In the 53 patients, EUS, TUS, and CT had a positive rate of 88.68%, 50.94%, and 62.26%, respectively, in detecting muddy stones of the common bile duct. As for the positive results confirmed by EST under ERCP, EUS had a sensitivity of 93.75%, a specificity of 60.00%, and an accuracy of 90.57% in detecting muddy stones of the common bile duct, while TUS had a sensitivity of 56.25%, a specificity of 100.00%, and an accuracy of 60.38% and CT had a sensitivity of 66.67%, a specificity of 80.00%, and an accuracy of 67.92%. There was a significant difference between EUS and CT in the accuracy in detecting muddy stones of the common bile duct (χ2=8.26, P=0.004), and there was also a significant difference in diagnostic accuracy between EUS and TUS (χ2=13.05, P < 0.001).  Conclusion  EUS is more accurate than TUS and CT in the diagnosis of muddy stones of the common bile duct, and instead of ERCP, EUS is thus recommended for suspected muddy stones of the common bile duct when TUS and CT fail to identify the lesions in clinical practice, so as to make a confirmed diagnosis and reduce related costs and complications.

     

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