Choledocholithiasis can be identified through multiple means, including a right upper quadrant ultrasound, endoscopic ultrasound (EUS), endoscopic retrograde cholangiography (ERCP), magnetic resonance cholangiopancreatography (MRCP), and intraoperative cholangiogram. Which modality is utilized is dependent, in part, upon the likelihood that a stone is present. Both the American Society for Gastrointestinal Endoscopy (ASGE) and the European Society of Gastrointestinal Endoscopy (ESGE) have proposed guidance to help clinicians risk-stratify the likelihood of choledocholithiasis. <\/p>\n\n\n\n
In this single-center prospective study, all patients with suspected choledocholithiasis were identified based on the prespecified criteria presence of epigastric or right upper quadrant abdominal pain associated with any one of the following: abnormal liver enzymes, bile duct dilation, or suspected bile duct stone on initial imaging. Patients were evaluated using ASGE 2010, ASGE 2019, and ESGE criteria. <\/p>\n\n\n\n
In total, 359 patients who met inclusion criteria were identified. The likelihood of stones being present when categorized as \u201chigh risk\u201d varied somewhat for ASGE 2019 (81.6%), ASGE 2010 (79.1%), and ESGE (83.1%) guidelines. In other words, nearly 20% of high-risk patients did not have stone disease. The ESGE criteria resulted in the highest number of patients requiring further testing with EUS or MRCP but the lowest number of patients undergoing unnecessary ERCP. The overall accuracy for the diagnosis of choledocholithiasis for ASGE 2010 criteria was 0.72 (95% confidence interval [CI], 0.67-0.76), ASGE 2019 was 0.73 (95% CI, 0.67-0.77), and ESGE was 0.73 (95% CI, 0.67-0.77). These differences were not statistically significant (P<\/em>=.9).<\/p>\n","protected":false},"excerpt":{"rendered":" Choledocholithiasis can be identified through multiple means, including a right upper quadrant ultrasound, endoscopic ultrasound (EUS), endoscopic retrograde cholangiography (ERCP), magnetic resonance cholangiopancreatography (MRCP), and intraoperative cholangiogram. Which modality is utilized is dependent, in part, upon the likelihood that a stone is present. Both the American Society for Gastrointestinal Endoscopy (ASGE) and the European Society … Read more<\/a><\/p>\n","protected":false},"template":"","categories":[1768,67],"tags":[854,3853,381,1489,3070,3854,2108,2128],"class_list":["post-14605","ec-news","type-ec-news","status-publish","hentry","category-asge-journal-scan","category-bauchspeicheldruese-pankreas","tag-choledocholithiasis","tag-endoscopic-retrograde-cholangiography","tag-ercp","tag-esge","tag-european-society-of-gastrointestinal-endoscopy","tag-magnetic-resonance-cholangiopancreatography","tag-mrcp","tag-pancreatobiliary"],"_links":{"self":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news\/14605","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/ec-news"}],"about":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/types\/ec-news"}],"wp:attachment":[{"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/media?parent=14605"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/categories?post=14605"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.endoscopy-campus.com\/en\/wp-json\/wp\/v2\/tags?post=14605"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}