Endoscopy 2020; 52(S 01): S154
DOI: 10.1055/s-0040-1704475
ESGE Days 2020 ePoster Podium presentations
Thursday, April 23, 2020 14:30 – 15:00 Biliary diagnosis ePoster Podium 3
© Georg Thieme Verlag KG Stuttgart · New York

THE YIELD OF FOCUSSED ENDOSCOPIC ULTRASOUND IN PATIENTS WITH UNEXPLAINED DILATATION OF COMMON BILE DUCT AND OR PANCREATIC DUCT AND CORRELATION WITH LIVER FUNCTION TESTS

V Parihar
1   Tallaght University Hospital, Department of Gastroenterology, Dublin, Ireland
,
G Offiah
1   Tallaght University Hospital, Department of Gastroenterology, Dublin, Ireland
,
Y Bashir
2   Tallaght University Hospital, Surgery, Dublin, Ireland
,
R Ballester-Clau
1   Tallaght University Hospital, Department of Gastroenterology, Dublin, Ireland
,
K Hazel
1   Tallaght University Hospital, Department of Gastroenterology, Dublin, Ireland
,
G Mellotte
1   Tallaght University Hospital, Department of Gastroenterology, Dublin, Ireland
,
NP Breslin
1   Tallaght University Hospital, Department of Gastroenterology, Dublin, Ireland
,
BM Ryan
1   Tallaght University Hospital, Department of Gastroenterology, Dublin, Ireland
3   Trinity College, Department of Clinical Medicine, Dublin, Ireland
,
Tallaght Pancreas Research Group › Institutsangaben
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Publikationsdatum:
23. April 2020 (online)

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Aims To investigate factors that are associated with positive findings at EUS in patients with dilated ducts and correlation with LFTs.

Methods Patients with EUS for unexplained dilated CBD and/or PD from 2012 to 2016 with available LFTs were included. CBD dilatation was defined as CBD diameter greater than 7mm with PD diameter more than 4 mm in the head and 3 mm in the body and tail was considered dilated. LFTs checked were bilirubin, ALT (alanine aminotransferase), ALKP(alkaline phosphatase) and GGT(gamma-glutamyl transferase). Elevated LFTs were defined as elevation of anyone of the above .

Results Among 2179 EUS procedures, 404 patients met the study criteria. 58.4% were female with mean age of 61.72±15.11 and 293/404 had elevated LFTs. 74% of patients had more than one imaging modality before EUS. EUS found a cause of dilated duct in 57% of total cases. Males (65%, p=0.008), patients with dilated CBD and PD (67% p=0.009), elevated bilirubin (72.6% p=0.000) and elevated AKLP (62.3% p=0.049) were associated with positive findings on EUS.

In patients with CBD dilatation alone, elevated bilirubin as compared to normal bilirubin was associated with a positive finding on EUS (p< 0.027) (66% of cases). In those with CBD and PD dilatation, age over 60 years (p=0.000), raised bilirubin (p< 0.022) and Alkaline Phosphatase

(p< 0.018) were associated with positive findings (78.2%, 81.6% and 76.6%respectively.) The predictors of positive findings on EUS in Multivariate analysis were: bilirubin (OR 2.07(CI 1.19-3.59) and male gender (OR 1.7(CI 1.14-2.25).

Conclusions EUS detects pathology missed on prior radio logical imaging in 57% of patients with dilated CBD and or PD especially in males and with raised bilirubin. We recommend early access to a diagnostic EUS in the diagnostic pathway of patients with dilated CBD and or PD.