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Comparative analysis of ERCP,IDUS,EUS and CT in predicting malignant bile duct strictures

World Journal of Gastroenterology 2014年第30期20卷 10495-10503页

作者： Hauke S Heinzow Sara Kammerer carina rammes Johannes Wessling Dirk Domagk Tobias Meister Department of Medicine B University of MünsterD-48149 MünsterGermany Department of Clinical Radiology University of MünsterD-48149 MünsterGermany Department of Radiology ClemenshospitalMünster University Teaching HospitalD-48153 MünsterGermany Department of Medicine Ⅱ HELIOS AlbertSchweitzer HospitalG?ttingen University Teaching HospitalD-37154 NortheimGermany

AIM:To compare endoscopic retrograde cholangio-pancreatography(ERCP),intraductal ultrasound(IDUS),endosonography(EUS),endoscopic transpapillary forceps biopsies(ETP)and computed tomography(CT)with respect to diagnosing malignant bile duct ***:A patient cohort with bile duct strictures of unknown etiology was examined by ERCP and IDUS,ETP,EUS,and *** sensitivity,specificity,and accuracy rates of the diagnostic procedures were calculated based on the definite diagnoses proved by histopathology or long-term follow-up in those patients who did not undergo *** each of the diagnostic measures,the sensitivity,specificity,and accuracy rates were *** all cases,the gold standard was the histopathologic staging of specimens or long-term follow-up of at least 12 mo.A comparison of the accuracy rates between the localization of strictures was performed by using the Mann-Whitney U-test and theχ2test as appropriate.A comparison of the accuracy rates between the diagnostic procedures was performed by using the McNemar’s *** were considered statistically significant if P<***:A total of 234 patients(127 males,107 females,median age 64,range 20-90 years)with indeterminate bile duct strictures were included.A total of 161patients underwent operative exploration;thus,a surgical histopathological correlation was available for those patients.A total of 113 patients had malignant disease proven by surgery;in 48 patients,benign disease was surgically *** these patients,the decision for surgical exploration was made due to the suspicion of malignant disease in multimodal diagnostics(ERCP,CT,or EUS).Fifty patients had a benign diagnosis and were followed by a surveillance protocol with a followup of at least 12 mo;the median follow-up was 34 ***-three patients had extended malignant disease,and thus were considered palliative.A comparison of the different diagnostic tools for detecting bile duct malignancy resulted in accura

关键词： Intraductal ultrasound Bile duct strictures Endoso

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