Utility of Endoscopic Ultra Sonography in Evaluation of Dilated Common Bile Duct of undetermined Etiology

Abstract

Dilated common bile duct (CBD) is commonly seen in clinical practice and usually represents an obstructive lesion limiting the flow of bile. The most common causes of dilated common bile duct are choledocholithiasis, passed common bile duct stone, post cholecystectomy state, ampullary neoplasia, cholangiocarcinoma and pancreatic head cancer. Generally, patients who present with cholestasis are evaluated with US or CT. However, these investigations are frequently inconclusive, and additional evaluation is required to establish the diagnosis. Over the last decade, several studies have demonstrated that EUS is effective in this setting. EUS combines endoscopy and US to provide remarkably detailed images of the pancrease and biliary tree. It uses higher frequency ultrasonic waves compared to traditional us and allow diagnostic tissue sampling via EUS guided fine needle aspiration (EUS FNA). The aim of this study is to assess the value of EUS in identifying the cause of CBD dilatation undiagnosed by transabdominal ultrasongraphy, CT or MRI. The study was done at The Gastroenterology and Hepatology Department, Kobry Elkobba Military hospital between August 2016 and August 2017. Written consents were taken from all patients in this study.