超声内镜诊断胆总管结石的临床价值

Clinical value of endoscopic ultrasonography in the diagnosis of choledocholithiasis

目的探讨超声内镜(Endoscopic ultrasonography,EUS)对胆总管结石的诊断价值。方法收集我院2009年9月至2011年9月胆总管结石患者105例,以内镜下十二指肠乳头括约肌切开术(Endoscopic Sphinctero-Papillotomy,EST)取出结石为诊断标准,评价EUS对胆总管结石的诊断价值。结果 105例患者EUS诊断胆总管结石83例,其中1例经EST未见结石;22例未见结石中,经EST取出高位胆管结石2例;EUS诊断胆总管结石的敏感性为97.6%,特异性为95.2%,准确性为97.1%,阳性预测值为98.8%,阴性预测值为90.9%。结论 EUS诊断胆总管结石可以和经内镜逆行胰胆管造影(Endoscopic retrograde cholangio-pancreatography,ER-CP)相媲美,而且具有更小的侵袭性。

Objective To study the value of endoscopic ultrasonography （EUS） in the diagnosis of choledocholithiasis. Methods 105 patients of choledocholithiasis admitted in our hospital from September 2009 and September 2011 were enrolled in this study. The stone was taken out by endoscopic sphinctero-papillotomy （EST） as diagnostic standard, to evaluate the value of EUS in the diagnosis of choledocholithiasis. Results Eighty-three out of the 105 patients with choledocholithiasis were diagnosed by EUS, including one patient detected with no stone by EST. Two of the remaining 22 patients had the stones taken out by EST. For the diagnosis of choledocholithiasis, EUS showed a sensitivity of 97.6%, a specificity of 95.2%, a positive predictive value of 98.8%, a negative predictive value of 90.9% and an overall accuracy of 97.1%. Conclusion For the diagnosis of choledocholithiasis, EUS was as accurate as endoscopic retrograde cholangio-pancreatography （ERCP）, which is less invasive.