title: Accuracy of ultrasonography in evaluation of level and cause of biliary obstruction: a prospective study.
abstract: OBJECTIVE
  To find out the accuracy of ultrasound in evaluation of level and cause of biliary obstruction.
  
  
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Radiology, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal. rudraghimire@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Ghimire
authors.forename: B
authors.initials: B
authors.lastname: Lohani
authors.forename: S
authors.initials: S
authors.lastname: Pradhan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications / Q000000981:diagnostic imaging; D002758:Cholangiography / Q000379:methods; D002779:Cholestasis / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography