[The value of computerized tomography and endoscopic retrograde cholangiopancreatography in the assessment of malignant jaundice].
US and direct cholangiography have considerably simplified the diagnostic workup of mechanical icterus. These procedures allow diagnosis of choledocholithiasis in most cases. We analyze the possible additional role of CT in the diagnostic workup of malignant jaundice in a retrospective study. Between January 1986 and December 1989. ERCP was performed in 37 patients with malignant jaundice. 21 of the lesions were located in the pancreas, 7 in the papilla and 6 in the bile duct; in 2 cases the choledochus was compressed by metastases and in one chronic pancreatitis was present. In 34 of 37 patients (92%), ERCP alone permitted a definite diagnosis. 22 patients underwent CT as the primary diagnostic procedure. In only 9 of these (41%) was an unequivocal diagnosis possible, as opposed to ERCP (19 of 22 or 86%). No complications of ERCP were observed. We therefore conclude that the diagnosis of malignant jaundice can be based on history, physical examination, laboratory results, US and ERCP alone. In the vast majority of cases CT is unnecessary.
Werth
B
B
Gastroenterologie, Kantonsspital Chur.
Kobler
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000150:complications; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D014463:Ultrasonography
Wertigkeit von Computertomographie und endoskopisch-retrograder Cholangio-Pankreatographie bei der Abklärung des malignen Ikterus.