TO DETERMINE THE DIAGNOSTIC ACCURACY OF ULTRASONOGRAPHY IN DETECTING CHOLEDOCHOLITHIASIS IN PATIENTS OF OBSTRUCTIVE JAUNDICE KEEPING MAGNETIC RESONANCE CHOLANGIOPANCREATOGRAPHY AS GOLD STANDARD.

Ana Rizvi, Mahjabeen Mahmood Kamal, Fariha Ahmad, Mamoona Shoukat, Shaghaf Iqbal, Nadia Ahmad, Ammara Ghafoor

Abstract


ABSTRACT

Objective: To determine the diagnostic accuracy of ultrasonography in detecting choledocholithiasis in obstructive jaundice patients taking magnetic resonance cholangiopancreatography as gold standard. Material and methods: This Cross-Sectional Validation Study was conducted at Department of Radiology, KRL Hospital, Islamabad from 31st January 2021 to 31st July 2021. A total of 150 patients of both gender presenting with Obstructive jaundice were included in the study. The patient underwent directly under a limited sonographic scan covering the area of pancreato-biliary region. The ultrasound was performed by using a curved low frequency probe (2-5 MHz). The pancreato-biliary region was evaluated with gray scale ultrasound. Findings from both ultrasound and MRCP were noted. Results: Age range in this study was from 18 to 70 years with mean age of 42.113±7.64 years and mean weight was 80.220±6.76 Kg. Ultrasound showed sensitivity of 76.3%, specificity 92.3%, diagnostic accuracy 86%, PPV 86.5% and NPV by 85.7%.  Conclusion: Ultrasound has a moderate sensitivity, high specificity and a high diagnostic accuracy in diagnosis of obstructive jaundice.

Keywords: Obstructive jaundice, Choledocholithiasis, Ultrasound, MRCP


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References

Rehman SFU, Ballance L, Rate A. Selective antegrade biliary stenting aids emergency laparoscopic cholecystectomy. J Laparoendosc Adv Surg Tech. 2018;28(12):1495-502.

Van-Sonnenberg E, Panchanathan R. Percutaneous transcholecystic management of choledocholithiasis: a next horizon for interventional radiologists?Radiology.2019;290(1):244-5.

Xiao LK, Xiang JF, Wu K, Fu X, Zheng MY, Song XX, et al. The reasonable drainage option after laparoscopic common bile duct exploration for the treatment of choledocholithiasis. Clin Res Hepatol Gastroenterol. 2018;42(6):564-9.

Frybova B, Drabek J, Lochmannova J, Douda L, Hlava S, Zemkova D, et al. Cholelithiasis and choledocholithiasis in children; risk factors for development. PLoS ONE. 2018;13(5):e0196475.

Wilkins T, Agabin E, Varghese J, Talukder A. Gallbladder dysfunction: cholecystitis, choledocholithiasis, cholangitis, and biliary dyskinesia. Prim Care. 2017;44(4):575-97.

Wennmacker SZ, Lamberts MP, Di Martino M, Drenth JP, Gurusamy KS, van Laarhoven CJ. Transabdominal ultrasound and endoscopic ultrasound for diagnosis of gallbladder polyps. Cochrane Database Syst Rev. 2018;8(8):CD012233.

Molvar C, Glaenzer B. Choledocholithiasis: evaluation, treatment, and outcomes. Semin InterventRadiol. 2016;33(4):268-76.

Alkarboly T, Fatih S, Hussein H, Ali T, Faraj H. The accuracy of transabdominal ultrasound in detection of the common bile duct stone as compared to endoscopic retrograde cholangiopancreatography (with literature review). Open J Gastroenterol. 2016;6:275-99.

Costa DAPD, Guerra JG, Goldman SM. Magnetic resonance cholangiopancreatography (MRCP) versus endosonography-guided fine needle aspiration (EUS-FNA) for diagnosis and follow-up of pancreatic intraductal papillary mucinous neoplasms. Arq Bras Cir Dig. 2019;32(4):e1471.

Hanif H, Khan SA, Muneer S, Adil SO. Diagnostic accuracy of ultrasound in evaluation of obstructive jaundice with MRCP as gold standard. Pak J Med Sci. 2020;36(4):652-6.

Hammarström LE, Holmin T, Stridbeck H, Ihse I. Routine preoperative infusion cholangiography versus intraoperative cholangiography at elective cholecystectomy: a prospective study in 995 patients. J Am Coll Surg. 1996;182:408–416.

Verma D, Kapadia A, Eisen GM, Adler DG. EUS vs MRCP for detection of choledocholithiasis. Gastrointest Endosc. 2006;64:248–254.

Polkowski M, Regula J, Tilszer A, Butruk E. Endoscopic ultrasound versus endoscopic retrograde cholangiography for patients with intermediate probability of bile duct stones: a randomized trial comparing two management strategies. Endoscopy. 2007;39:296–303.

Karakan T, Cindoruk M, Alagozlu H, Ergun M, Dumlu S, Unal S. EUS versus endoscopic retrograde cholangiography for patients with intermediate probability of bile duct stones: a prospective randomized trial. Gastrointest Endosc. 2009;69:244–252.

Peters JH, Ellison EC, Innes JT, Liss JL, Nichols KE, Lomano JM, Roby SR, Front ME, Carey LC. Safety and efficacy of laparoscopic cholecystectomy. A prospective analysis of 100 initial patients. Ann Surg. 1991;213:3–12.

Soper NJ, Stockmann PT, Dunnegan DL, Ashley SW. Laparoscopic cholecystectomy. The new ‘gold standard’? Arch Surg. 1992;127:917– 921; discussion 921-923.

Kiviluoto T, Sirén J, Luukkonen P, Kivilaakso E. Randomised trial of laparoscopic versus open cholecystectomy for acute and gangrenous cholecystitis. Lancet. 1998;351:321–325.

Phillips E, Daykhovsky L, Carroll B, Gershman A, Grundfest WS. Laparoscopic cholecystectomy: instrumentation and technique. J Laparoendosc Surg. 1990;1:3–15.

Machi J, Tateishi T, Oishi AJ, Furumoto NL, Oishi RH, Uchida S, Sigel

B. Laparoscopic ultrasonography versus operative cholangiography during laparoscopic cholecystectomy: review of the literature and a comparison with open intraoperative ultrasonography. J Am Coll Surg. 1999;188:360– 367.

Jacobs M, Verdeja JC, Goldstein HS. Laparoscopic choledocholithotomy. J Laparoendosc Surg. 1991;1:79–82.

Petelin JB. Laparoscopic approach to common duct pathology. Surg Laparosc Endosc. 1991;1:33–41.

Nathanson LK, O’Rourke NA, Martin IJ, Fielding GA, Cowen AE, Roberts RK, Kendall BJ, Kerlin P, Devereux BM. Postoperative ERCP versus laparoscopic choledochotomy for clearance of selected bile duct calculi: a randomized trial. Ann Surg. 2005;242:188–192.

Siegel JH, Ben-Zvi JS, Pullano WE. Endoscopic electrohydraulic lithotripsy. Gastrointest Endosc. 1990;36:134–136.

Lux G, Ell C, Hochberger J, Müller D, Demling L. The first successful endoscopic retrograde laser lithotripsy of common bile duct stones in man using a pulsed neodymium-YAG laser. Endoscopy. 1986;18:144–145.

Ponchon T, Martin X, Barkun A, Mestas JL, Chavaillon A, Boustière C. Extracorporeal lithotripsy of bile duct stones using ultrasonography for stone localization. Gastroenterology. 1990;98:726–732.


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