Endoscopic Ultrasound Versus Conventional Ultrasonography as A Diagnostic Tool for Patients with Obstructive Jaundice

Abstract

In patient presented with jaundice, the initial examination of choice is transabdominal ultrasonography which reveals liver parenchymal changes, cirrhosis and assess hepatic vascularity and evaluation of intrahepatic, extrahepatic biliary system. In the current study, we enrolled 60 patients presenting with obstructive jaundice as evident by laboratory testing (Total bilirubin, direct bilirubin, alkaline phosphatase) and TUS in the form of dilated CBD and IHBRDs. All patients then underwent EUS with comments on liver (any deposits, IHBRDs), GB (pathology, content), CBD (diameter, pathology including stone or mass and stricture), pancreas (mass, calcification, enlargement, pancreatic duct diameter. Also assessment of vascular invasion was done in case of malignancy and lymphadenopathy. Comparison between TUS and EUS was done regarding CBD diameter and pathology, IHBRDs and pancreatic lesion EUS provided better visualization of CBD and IHBRDs with diagnosis of pathological lesion including stones, malignancy. EUS showed better accuracy in the diagnosis of pancreatic pathology including inflammation and malignancy and extent of the tumor including local extent, lymphatic spread and vascular invasion. Our study showed highly significant difference between EUS and TUS in detection of pancreatic lesions as many cases showed as enlarged pancreas showed by EUS to be pancreatic mass, higher number of pancreatic mass detected by EUS than US.