Publication: Accuracy of ultrasonography in evaluation of level and cause of biliary obstruction: a prospective study
Date
2005
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Aim: To find out the accuracy of ultrasound in evaluation of level and cause of biliary obstruction. Materials and
methods: Forty-five patients (26 to 86 years of age) with suspected biliary obstruction underwent Ultrasonography
followed by Direct Cholangiograms (Percutaneous Transhepatic Cholangiography / Endoscopic Retrograde
Cholangiography). The levels of biliary obstructions were grouped as hilar, suprapancreatic and intrapancreatic.
Similarly the causes were grouped as malignant and benign. Diagnosis was confirmed either at surgery or
histopathologically (USG-guided FNAC or ERC-biopsy). Results: Ultrasonography accurately identified the level
of obstruction in 89 %( hilar), 91 %( suprapancreatic) and 87 %( intrapancreatic) cases. Malignancy was found in 33
patients and remaining 12 had benign diseases. USG accurately identified malignant and benign causes in 91% and
84% cases respectively. Findings were found to be statistically significant (p-value=<0.05 at 95%confidence
interval). Conclusion: This study showed that USG has high accuracy in identifying the level and cause of biliary
obstruction. Considering cost, availability and patient friendly nature, Ultrasound should be the first imaging
modality of choice in evaluation of biliary obstruction.
Key words: Ultrasound, biliary obstruction, direct cholangiogram