Endoscopic ultrasound and fine-needle aspiration of unexplained bile duct strictures

Jeffrey H. Lee, Ronald Salem, Harry Aslanian, Mary Chacho, Mark Topazian

Research output: Contribution to journalReview article

115 Citations (Scopus)

Abstract

OBJECTIVES: The aim of this study was to assess the utility of endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) in patients with unexplained common bile duct strictures after endoscopic retrograde cholangiopancreatography (ERCP) and intraductal tissue sampling. METHODS: Records were reviewed for all subjects undergoing EUS for evaluation of unexplained bile duct strictures at our institution. 40 subjects had either a final histologic diagnosis (24) or no evidence of malignancy after at least 1 yr of follow-up (16). RESULTS: The finding of a pancreatic head mass and/or an irregular bile duct wall had sensitivity for malignancy of 88%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 84%. Bile duct wall thickness ≥3 mm had a sensitivity for malignancy of 79%, specificity of 79%, positive predictive value of 73%, and negative predictive value of 80%. Sensitivity of EUS FNA for malignancy was 47% with specificity 100%, positive predictive value 100%, and negative predictive value 50%. CONCLUSIONS: Sonographic features may be more sensitive than EUS FNA for diagnosis of unexplained bile duct strictures and include presence of a pancreatic mass, an irregular bile duct wall, or bile duct wall thickness < 3 mm. EUS FNA cytology is specific but insensitive for diagnosis. EUS improves the diagnosis of otherwise unexplained bile duct strictures.

Original languageEnglish (US)
Pages (from-to)1069-1073
Number of pages5
JournalAmerican Journal of Gastroenterology
Volume99
Issue number6
DOIs
StatePublished - Jun 1 2004

Fingerprint

Fine Needle Biopsy
Bile Ducts
Pathologic Constriction
Neoplasms
Endoscopic Retrograde Cholangiopancreatography
Common Bile Duct
Cell Biology

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Endoscopic ultrasound and fine-needle aspiration of unexplained bile duct strictures. / Lee, Jeffrey H.; Salem, Ronald; Aslanian, Harry; Chacho, Mary; Topazian, Mark.

In: American Journal of Gastroenterology, Vol. 99, No. 6, 01.06.2004, p. 1069-1073.

Research output: Contribution to journalReview article

Lee, Jeffrey H. ; Salem, Ronald ; Aslanian, Harry ; Chacho, Mary ; Topazian, Mark. / Endoscopic ultrasound and fine-needle aspiration of unexplained bile duct strictures. In: American Journal of Gastroenterology. 2004 ; Vol. 99, No. 6. pp. 1069-1073.
@article{f8326915fc9b4903b626af697cfc0539,
title = "Endoscopic ultrasound and fine-needle aspiration of unexplained bile duct strictures",
abstract = "OBJECTIVES: The aim of this study was to assess the utility of endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) in patients with unexplained common bile duct strictures after endoscopic retrograde cholangiopancreatography (ERCP) and intraductal tissue sampling. METHODS: Records were reviewed for all subjects undergoing EUS for evaluation of unexplained bile duct strictures at our institution. 40 subjects had either a final histologic diagnosis (24) or no evidence of malignancy after at least 1 yr of follow-up (16). RESULTS: The finding of a pancreatic head mass and/or an irregular bile duct wall had sensitivity for malignancy of 88{\%}, specificity of 100{\%}, positive predictive value of 100{\%}, and negative predictive value of 84{\%}. Bile duct wall thickness ≥3 mm had a sensitivity for malignancy of 79{\%}, specificity of 79{\%}, positive predictive value of 73{\%}, and negative predictive value of 80{\%}. Sensitivity of EUS FNA for malignancy was 47{\%} with specificity 100{\%}, positive predictive value 100{\%}, and negative predictive value 50{\%}. CONCLUSIONS: Sonographic features may be more sensitive than EUS FNA for diagnosis of unexplained bile duct strictures and include presence of a pancreatic mass, an irregular bile duct wall, or bile duct wall thickness < 3 mm. EUS FNA cytology is specific but insensitive for diagnosis. EUS improves the diagnosis of otherwise unexplained bile duct strictures.",
author = "Lee, {Jeffrey H.} and Ronald Salem and Harry Aslanian and Mary Chacho and Mark Topazian",
year = "2004",
month = "6",
day = "1",
doi = "10.1111/j.1572-0241.2004.30223.x",
language = "English (US)",
volume = "99",
pages = "1069--1073",
journal = "American Journal of Gastroenterology",
issn = "0002-9270",
publisher = "Nature Publishing Group",
number = "6",

}

TY - JOUR

T1 - Endoscopic ultrasound and fine-needle aspiration of unexplained bile duct strictures

AU - Lee, Jeffrey H.

AU - Salem, Ronald

AU - Aslanian, Harry

AU - Chacho, Mary

AU - Topazian, Mark

PY - 2004/6/1

Y1 - 2004/6/1

N2 - OBJECTIVES: The aim of this study was to assess the utility of endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) in patients with unexplained common bile duct strictures after endoscopic retrograde cholangiopancreatography (ERCP) and intraductal tissue sampling. METHODS: Records were reviewed for all subjects undergoing EUS for evaluation of unexplained bile duct strictures at our institution. 40 subjects had either a final histologic diagnosis (24) or no evidence of malignancy after at least 1 yr of follow-up (16). RESULTS: The finding of a pancreatic head mass and/or an irregular bile duct wall had sensitivity for malignancy of 88%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 84%. Bile duct wall thickness ≥3 mm had a sensitivity for malignancy of 79%, specificity of 79%, positive predictive value of 73%, and negative predictive value of 80%. Sensitivity of EUS FNA for malignancy was 47% with specificity 100%, positive predictive value 100%, and negative predictive value 50%. CONCLUSIONS: Sonographic features may be more sensitive than EUS FNA for diagnosis of unexplained bile duct strictures and include presence of a pancreatic mass, an irregular bile duct wall, or bile duct wall thickness < 3 mm. EUS FNA cytology is specific but insensitive for diagnosis. EUS improves the diagnosis of otherwise unexplained bile duct strictures.

AB - OBJECTIVES: The aim of this study was to assess the utility of endoscopic ultrasound (EUS) with fine-needle aspiration (FNA) in patients with unexplained common bile duct strictures after endoscopic retrograde cholangiopancreatography (ERCP) and intraductal tissue sampling. METHODS: Records were reviewed for all subjects undergoing EUS for evaluation of unexplained bile duct strictures at our institution. 40 subjects had either a final histologic diagnosis (24) or no evidence of malignancy after at least 1 yr of follow-up (16). RESULTS: The finding of a pancreatic head mass and/or an irregular bile duct wall had sensitivity for malignancy of 88%, specificity of 100%, positive predictive value of 100%, and negative predictive value of 84%. Bile duct wall thickness ≥3 mm had a sensitivity for malignancy of 79%, specificity of 79%, positive predictive value of 73%, and negative predictive value of 80%. Sensitivity of EUS FNA for malignancy was 47% with specificity 100%, positive predictive value 100%, and negative predictive value 50%. CONCLUSIONS: Sonographic features may be more sensitive than EUS FNA for diagnosis of unexplained bile duct strictures and include presence of a pancreatic mass, an irregular bile duct wall, or bile duct wall thickness < 3 mm. EUS FNA cytology is specific but insensitive for diagnosis. EUS improves the diagnosis of otherwise unexplained bile duct strictures.

UR - http://www.scopus.com/inward/record.url?scp=3142755852&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3142755852&partnerID=8YFLogxK

U2 - 10.1111/j.1572-0241.2004.30223.x

DO - 10.1111/j.1572-0241.2004.30223.x

M3 - Review article

C2 - 15180727

AN - SCOPUS:3142755852

VL - 99

SP - 1069

EP - 1073

JO - American Journal of Gastroenterology

JF - American Journal of Gastroenterology

SN - 0002-9270

IS - 6

ER -