Background: Transabdominal Ultrasound (TUS) and other imaging modalities like Computed tomography (CT) or magnetic resonance cholangiopancreatography (MRCP) can't demonstrate all the causes of biliary obstruction.
Aim of the Work: This work aimed to evaluate the role of Endoscopic Ultrasound (EUS) in cases with obstructive jaundice with no definite cause detected by other imaging modalities.
Patients and Methods: This is a prospective cohort study on 80 patients presented with manifestations suggestive of obstructive jaundice. Patients underwent history taking, clinical examination, and routine laboratory investigations as well as tumor markers. All Patients were examined by TUS, CT, MRCP, and EUS. The final diagnosis was determined by tissue pathology and a four-month follow-up. Patients with CBD stones were referred for Endoscopic retrograde cholangiopancreatography (ERCP), while patients with operable tumors were sent for surgery. Patients with inoperable tumors were referred for oncology consultation.
Results: 80 patients presented with obstructive jaundice (58.7% female). As regard, the mean age of the patients was 50.7years.
The common bile duct (CBD) mean diameter for all patients in TUS, CT, MRCP, and EUS was 10.7mm, 11mm, 11.5mm, and 12.4mm, respectively.The most common finding were choledocholithiasis 26 (32.5%), pancreaticobiliary malignancy 44 ( 55.1%), chronic pancreatitis 4 (5%), portal biliopathy 1 (1.3%), and no pathological obstruction 5 (6.3%). The overall accuracy and sensitivity of EUS for patients diagnosed with pancreaticobiliary malignancy were 95.1%, 95.9%, respectively.
Conclusion: EUS is thought to be the best diagnostic imaging modality for diagnosing the causes of biliary obstruction with inconclusive, other imaging modalities.