| 총담관결석의 진단에서 내시경초음파검사의 유용성 |
| 유성수·김은영·천종운·서창진·조자경·하형근·정진태·권중구·이창형·김호각 |
| 대구가톨릭대학교 의과대학 내과학교실 |
| The Usefulness of Endoscopic Ultrasonography in the Diagnosis of Common Bile Duct Stones |
| Sung Soo You, M.D., Eun Young Kim, M.D., Jong Woon Cheon, M.D., Chang Jin Seo, M.D., Ja Kyoung Cho, M.D., Hyung Keun Ha, M.D., Jin Tae Jung, M.D., Joong Goo Kwon, M.D.,Chang Hyeong Lee, M.D. and Ho Gak Kim, M.D. |
| Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea |
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| Abstract |
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Background/Aims:
Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for diagnosis and treatment of common bile duct stones (CBDS). However it is associated with some complications. Endoscopic ultrasonography (EUS) is an efficient diagnostic tool for CBDS with better accuracy than ultrasonography (USG) or computed tomography (CT) and lower complication rate than ERCP. We evaluated the diagnostic usefulness of EUS in suspicious CBDS.
Methods:
From Oct. 2001 to Mar. 2004, 84 patients with the suspicion of CBDS, without definite evidence on CT and/or USG were evaluated with EUS. The reports were reviewed retrospectively.
Results:
Patients were 38 males, 46 females with mean age of 56 years old. CBDS were found in 25 (29.8%) patients. In the diagnosis of CBDS undetected in CT and/or USG, EUS gave 96% sensitivity, 96.6% specificity, 92.3% positive predictive value and 98.3% negative predictive value. When CBDS were found in EUS, the average sizes of CBD and CBDS were 8.8 mm (4∼16.7) and 6.4 mm (3.3∼9.1) respectively. Diagnostic ERCP was avoided in 54 (64.3%). EUS provided additional diagnosis such as gallbladder stones, gallbladder cancer, ampullary cancer and adenoma. No complication was associated with EUS.
Conclusions:
EUS is reasonably safe and accurate procedure in detecting CBDS. EUS may possibly replace diagnostic ERCP in CBDS. (Korean J Gastrointest Endosc 2005;30:249256) |
| Key Words:
Endoscopic ultrasonography, Common bile duct stones, Usefulness |
| 주요어:
총담관결석, 내시경초음파검사, 유용성 |
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