The role of endoscopic ultrasound in biliary strictures

被引：6
作者：
Conway J.D. [1 ]
Mishra G. [1 ]
机构：
[1] Section on Gastroenterology, Wake Forest University Health Sciences, Winston-Salem, NC 27157, Medical Center Boulevard
来源：
Current Gastroenterology Reports | 2008年 / 10卷 / 2期
关键词：
Bile Duct; Endoscopic Ultrasound; Biliary Stricture; Bile Duct Stricture; Biliary Decompression;
D O I：
10.1007/s11894-008-0037-4
中图分类号：
学科分类号：
摘要：
The role of endoscopic ultrasound (EUS) in the diagnosis of biliary strictures is well established, and emerging evidence suggests it may also play a therapeutic role. Differentiating between benign and malignant causes of biliary strictures can be challenging, but EUS can aid in their diagnosis and may predict resectability. The diagnostic yield of EUS combined with fine-needle aspiration (FNA) is excellent, especially in distal bile duct strictures, and far surpasses endoscopic retrograde cholangiopancreatography (ERCP) with brushings. Intraductal ultrasound may add to the diagnostic sensitivity of ERCP with brushings when no mass is seen on cross-sectional imaging or EUS, or when EUS with FNA is negative and suspicion of cancer persists. EUS-guided cholangiography is an emerging technique that may aid biliary decompression when ERCP has failed or is not possible; however, new therapeutic echoendoscopes or accessories are needed before the use of this technique can become more widespread. © Springer Science+Business Media, LLC 2008.
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收藏
页码：157 / 162
页数：5
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  • [1] Garrow D., Miller S., Sinha D., Et al., Endoscopic ultrasound: A meta-analysis of test performance in suspected biliary obstruction, Clin Gastroenterol Hepatol, 5, pp. 616-623, (2007)
  • [2] Romagnuolo J., Bardou M., Rahme E., Et al., Magnetic resonance cholangiopancreatography: A meta-analysis of test performance in suspected biliary disease, Ann Intern Med, 139, pp. 547-557, (2003)
  • [3] Lee J.H., Salem R., Aslanian H., Et al., Endoscopic ultrasound and fine-needle aspiration of unexplained bile duct strictures, Am J Gastroenterol, 99, pp. 1069-1073, (2004)
  • [4] Rosch T., Braig C., Gain T., Et al., Staging of pancreatic and ampullary carcinoma by endoscopic ultrasonography. Comparison with conventional sonography, computed tomography, and angiography, Gastroenterology, 102, pp. 188-199, (1992)
  • [5] Brugge W.R., Lee M.J., Kelsey P.B., Et al., The use of EUS to diagnose malignant portal venous system invasion by pancreatic cancer, Gastrointest Endosc, 43, pp. 561-567, (1996)
  • [6] Aslanian H., Salem R., Lee J., Et al., EUS diagnosis of vascular invasion in pancreatic cancer: Surgical and histologic correlates, Am J Gastroenterol, 100, pp. 1381-1385, (2005)
  • [7] Conway J., Hawes R., The expanding role of endoscopic ultrasound in pancreatic diseases, Rev Gastroenterol Disord, 4, pp. 201-208, (2006)
  • [8] Eloubeidi M.A., Tamhane A., Varadarajulu S., Wilcox C.M., Frequency of major complications after EUS-guided FNA of solid pancreatic masses: A prospective evaluation, Gastrointest Endosc, 63, pp. 622-629, (2006)
  • [9] Raut C.P., Grau A.M., Staerkel G.A., Et al., Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration in patients with presumed pancreatic cancer, J Gastrointest Surg, 7, pp. 118-126, (2003)
  • [10] Agarwal B., Abu-Hamda E., Molke K.L., Et al., Endoscopic ultrasound-guided fine needle aspiration and multidetector spiral CT in the diagnosis of pancreatic cancer, Am J Gastroenterol, 99, pp. 844-850, (2004)
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