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Intraductal ultrasound substantiates diagnostics of bile duct strictures of uncertain etiology

World Journal of Gastroenterology 2013年第6期19卷 874-881页

作者： Tobias Meister Hauke S Heinzow carina woestmeyer Philipp Lenz Josef Menzel Torsten Kucharzik Wolfram Domschke Dirk Domagk Department of Medicine B University of Münster Department of Medicine Ⅱ HELIOS AlbertSchweitzer University Teaching Hospital Department of MedicineⅡ Klinikum IngolstadtD-85049 IngolstadtGermany Department of Medicine University Teaching Hospital Lüneburg

AIM:To report the largest patient cohort study investigating the diagnostic yield of intraductal ultrasound (IDUS) in indeterminate strictures of the common bile ***:A patient cohort with bile duct strictures of unknown etiology was examined by ***,specificity and accuracy rates of IDUS were calculated relating to the definite diagnoses proved by histopathology or long-term follow-up in those patients who did not undergo *** of the endosonographic report allowed drawing conclusions with respect to the T and N staging in 147 *** staging was compared to the postoperative histopathological staging data allowing calculation of sensitivity,specificity and accuracy rates for T and N *** endoscopic retrograde cholangio-pancreatography and IDUS procedures were performed under fluoroscopic guidance using a side-viewing duodenoscope (Olympus TJF 160,Olympus,Ltd.,Tokyo,Japan).All procedures were performed under conscious sedation (propofol combined with pethidine) according to the German *** IDUS,a 6 F or 8 F ultrasound miniprobe was employed with a radial scanner of 15-20 MHz at the tip of the probe (Aloka Co.,Tokyo,Japan).RESULTS:A total of 397 patients (210 males,187 females,mean age 61.43 ± 13 years) with indeterminate bile duct strictures were *** hundred and sixty-four patients were referred to the department of surgery for operative exploration,thus surgical histopathological correlation was available for those *** of 264 patients,174 had malignant disease proven by surgery,in 90 patients benign disease was *** these patients decision for surgical exploration was made due to suspicion for malignant disease in multimodal diagnostics (computed tomography scan,endoscopic ultrasound or magnetic resonance imaging).Twenty benign bile duct strictures were misclassified by IDUS as malignant while 14 patients with malignant strictures were initially misdiagnosed by IDUS as benign resulting in s

关键词： Intraductal ultrasound Bile duct strictures Accuracy

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