内镜超声检查对胆总管无扩张伴可疑胆总管结石的诊断价值

目的 探讨胆总管无扩张伴可疑胆总管结石患者（CBDS）行超声内镜检查（EUS）的价值.方法 对33例经多次腹部B超检查诊断胆囊结石,胆总管直径〈8 mm,未发现CBDS但有急性胰腺炎、阻塞性黄疸或反复胆绞痛等病史之一的患者行EUS,并与手术或ERCP结果进行比较.结果 33例患者行EUS,20例发现CBDS.经进一步手术或ERCP,该20例患者中有16例证实有CBDS.EUS对本组病例CBDS诊断的灵敏度为100%,特异度为76.5%,阳性预测价值为80%,阴性预测价值为100%.结论 对胆总管无扩张但有可疑CBDS者行EUS检查有较高的临床价值.

Diagnostic significance of EUS for suspected choledocholithiasis in non-cholangiectasis

Objective To investigate the diagnostic significance of endoscopic ultrasonography (EUS) for suspected choledocholithiasis in non-cholangiectasis. Methods EUS was performed on 33 patients with cholecystolithiasis, whose common bile duct diameters were less than 8 mm, with one of the histories of acute pancreatitis, obstructive jaundice or recurrent biliary colic, but without common bile duct stone (CBDS). The results were compared with surgical or ERCP findings. Results Twenty cases in 33 were diagnosed ascholedocholithiasis by EUS. Sixteen of the 20 cases were confirmed as CBDS with further operation or ERCP. Compared with the results of surgery or ERCP, the sensitivity, specificity, positive prediction value and negative prediction value of EUS for choledocholithiasis were 100% , 76. 5% , 80% and 100% respectively. Conclusion EUS is of high diagnostic significance for suspected choledocholithiasis in non-cholangiectasis.