The Role of Endosonography in Patients With Moderate and High Probability of Choledocholithiasis

Abstract

Aim: In this study, we aimed to investigate the diagnostic efficiency and place of EUS in clinical practice in patients with moderate to a high probability of choledocholithiasis according to their ASGE score. Material and Method: This study includes patients with moderate to high risk of CBDSs who were admitted to the Department of Gastroenterology between August 2015-August 2016. The results of patients undergoing EUS and ERCP for suspected choledocholithiasis were retrospectively reviewed from the hospital registry. Results: Two hundred and twenty nine patients were included in the present study and 56.3% of the patients (n=129) were female, and the average age of the patients was 62.8±18.3 (20–91). The sensitivity of EUS was found to be 89.2%. The specificity was 94.6%, the positive predictive value was 95.6%, and the negative predictive value was 86.9%. In addition, the choledochal diameter measured in AUS and EUS was found to have diagnostic values in predicting the CBDSs [AUC (95% GA p); respectively, 0.617 (0.409–0.825) p=0.310 and 0.765 (0.619–0.915) 0.020]. Conclusion: Endosonography is both a high-diagnostic and a low-invasive diagnostic method, so it is increasingly used in patients with suspected CBDSs. Referral of suspected patients with CBDSs to a center with EUS and an experienced endoscopist will ensure that the patient receives the correct diagnosis and is not subjected to unnecessary invasive procedures.