EUS and Common bile duct stones

Authors Christine Bergele, M. Giovannini.


Choledocholithiasis is a common disorder, especially in
patients older than 60 years, as common bile duct stones
may be present in 15% to 60% of cases in this special sample
of population. Until recently, endoscopic retrograde cholangiography
(ERC), which is a very reliable method for
visualizing and extracting gallstones in the same session,
was considered the gold-standard for suspected choledocholithiasis;
however the not negligible complication rate
of diagnostic and therapeutic ERC has led to the evolution
of EUS. EUS has proved to be of great sensitivity (up to
97%) for detecting even tiny stones that can easily be masked
by contrast medium during ERCP, without any complications
related to the procedure, and with a NPV reaching
100%, meaning that it can accurately and safely identify
patients with choledocholithiasis and thereby avoid inappropriate
instrumental exploration of the duct.
Key words: EUS, choledocholithiasis, biliary pancreatitis