Endoscopic ultrasound in common bile duct dilatation withnormal liver enzymes

• 作者: Claudio De Angelis Mario Rizzetto. Mauro Bruno Milena Marietti Rinaldo Pellicano
• 来源期刊: 世界胃肠内镜杂志：英文版（电子版）
• 学科: 医学
• 关键词: UNEXPLAINED common BILE DUCT DILATATION Endoscopic ULTRASOUND Normal liver ENZYMES
• 年，卷（期）: 2015,（8）
• 页码范围: 799-805
• 页数: 7页
• 分类号: R

摘要

In recent years, the description of isolated bile ductdilatation has been increasingly observed in subjectswith normal liver function tests and nonspecific abdominalsymptoms, probably due to the widespread useof high-resolution imaging techniques. However, thereis scant literature about the evolution of this conditionand the impact of endoscopic ultrasound （EUS） in thediagnostic work up. When noninvasive imaging tests（transabdominal ultrasound, computed tomography ormagnetic resonance cholangiopancreatography） fail toidentify the cause of dilatation and clinical or biochemicalalarm signs are absent, the probability of having biliarydisease is considered low. In this setting, using EUS,the presence of pathologic findings （choledocholithiasis,strictures, chronic pancreatitis, ampullary or pancreatictumors, cholangiocarcinoma）, not always with a benigncourse, has been observed. The aim of this review hasbeen to evaluate the prevalence of disease among nonjaundicedpatients without signs of cytolysis and/orcholestasis and the assessment of EUS yield. Datapoint out to a promising role of EUS in the identificationof a potential biliary pathology. EUS is a low invasivetechnique, with high accuracy, that could play a doublecost-effective role identifying pathologic conditionswith dismal prognosis, in asymptomatic patients withnegative prior imaging tests, and excluding pathologicconditions and further follow-up in healthy subjects.