| 담낭결석 환자에서 총담관결석 진단을 위한 내시경초음파검사의 유용성 |
| 구자설ㆍ이홍식ㆍ정성우ㆍ한우식ㆍ이종섭ㆍ임형준ㆍ이상우ㆍ최재현ㆍ김창덕ㆍ류호상 |
| 고려대학교 의과대학 내과학교실, 소화기연구소 |
| Usefulness of Endoscopic Ultrasonography for Diagnosing Choledocholithiasis in Patients with Gallbladder Stones |
| Ja Seol Koo, M.D., Hong Sik Lee, M.D., Sung Woo Jung, M.D., Woo Sik Han, M.D., Jong Sup Lee, M.D., Hyung Joon Yim, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D. and Ho Sang Ryu, M.D. |
| Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea |
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| Abstract |
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Background/Aims:
CBD stones (CBDS) are generally thought to originate from the gallbladder. Recently, EUS appears to be the best imaging method for making the diagnosis of CBDS. We conducted this study to evaluate the role of EUS for detecting CBDS in patients with gallbladder stones (GBS) and to determine the parameters for predicting CBDS.
Methods:
From April 2003 to March 2005, 117 GBS patients were enrolled. The patients' clinical and laboratory findings and the radiologic findings of US, EUS, CT and ERCP were reviewed. The sensitivity, specificity, PPV and NPV of EUS for detecting CBDS were evaluated by using ERCP and intraoperative CBD exploration as the gold standard for diagnosing CB.
Results:
A total 117 patients received EUS and no complications were encountered. After performing ERCP and/or intraoperative exploration, 62 of the patients were examined for determining the presence or absence of CBDS. EUS shows 95% sensitivity and 95% specificity for identifying CBDS. The overall agreement between EUS and ERCP was 94.8%. The patients with CBDS were older than those without CBDS. Fever, jaundice and cholangitis were more prevalent in the patients with CBDS. The results of liver function tests were elevated more frequently in the patients with CBDS (p＜0.05).
Conclusions:
EUS is an accurate and minimally invasive method for diagnosing CBDS. Evaluating CBD in patients with gallstones is selectively recommended according to clinical and laboratory findings. (Korean J Gastrointest Endosc 2007;35:228-234) |
| Key Words:
Endoscopic ultrasonography; Cholangiopancreatography, Endoscopic retrograde; Choledocholithiasis; Gallstones |
| 주요어:
내시경초음파검사, 내시경역행췌담도조영술, 총담관결석, 담낭결석 |
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