Endoscopic ultrasonography in detection of cholelithiasis in patients with biliary pain and negative transabdominal ultrasonography.
BACKGROUND
The aim of the study was to evaluate endoscopic ultrasonography (EUS) as a single method for diagnosing cholecystolithiasis in patients with a clinical suspicion of cholecystolithiasis, but with a normal transabdominal ultrasonography (TUS).


METHODS
A prospective study was performed on patients with biliary type of colic and normal US of the gallbladder. All patients had at least one normal TUS examination (mean 2.1, range 1-5) performed by an experienced radiologist. All patients were subsequently examined with EUS. EUS examination was performed with either a mechanical radial scanning echo-endoscope (Olympus GF-UM20) or a linear echo-endoscope (Pentax FG32-UA or FG34-UA). Patients in whom EUS demonstrated cholecystolithiasis were offered laparoscopic cholecystectomy within 2 weeks.


RESULTS
A total of 35 patients (31 F and 4 M) were included. In 18 out of 35 (52.4%) patients cholecystolithiasis was diagnosed by EUS. In 15 out of 17 patients the EUS diagnosis was verified by surgery. At follow-up after 12 months, 13 of the 15 patients (87%) with verified gallbladder stones had no abdominal discomfort, whereas 2 patients (13%) complained of persistent and unchanged abdominal pain.


CONCLUSIONS
EUS seems to be a promising imaging method in the detection of microlithiasis in the gallbladder in patients with clear biliary colic and normal transabdominal US.
Thorbøll
J
J
Dept. of Surgical Gastroenterology D, Gentofte University Hospital, Hellerup, Denmark.
Vilmann
P
P
Jacobsen
B
B
Hassan
H
H
D000005:Abdomen / Q000000981:diagnostic imaging; D000293:Adolescent; D000328:Adult; D000368:Aged; D002769:Cholelithiasis / Q000150:complications / Q000000981:diagnostic imaging*; D003085:Colic / Q000000981:diagnostic imaging* / Q000209:etiology; D003135:Common Bile Duct / Q000000981:diagnostic imaging; D003549:Cystic Duct / Q000000981:diagnostic imaging; D019160:Endosonography; D005260:Female; D005704:Gallbladder / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies