title: Endoscopic ultrasound in common bile duct dilatation with normal liver enzymes.
abstract: In recent years, the description of isolated bile duct dilatation has been increasingly observed in subjects with normal liver function tests and nonspecific abdominal symptoms, probably due to the widespread use of high-resolution imaging techniques. However, there is scant literature about the evolution of this condition and the impact of endoscopic ultrasound (EUS) in the diagnostic work up. When noninvasive imaging tests (transabdominal ultrasound, computed tomography or magnetic resonance cholangiopancreatography) fail to identify the cause of dilatation and clinical or biochemical alarm signs are absent, the probability of having biliary disease is considered low. In this setting, using EUS, the presence of pathologic findings (choledocholithiasis, strictures, chronic pancreatitis, ampullary or pancreatic tumors, cholangiocarcinoma), not always with a benign course, has been observed. The aim of this review has been to evaluate the prevalence of disease among non-jaundiced patients without signs of cytolysis and/or cholestasis and the assessment of EUS yield. Data point out to a promising role of EUS in the identification of a potential biliary pathology. EUS is a low invasive technique, with high accuracy, that could play a double cost-effective role: identifying pathologic conditions with dismal prognosis, in asymptomatic patients with negative prior imaging tests, and excluding pathologic conditions and further follow-up in healthy subjects.
authors.affiliation: Claudio De Angelis, Milena Marietti, Mauro Bruno, Rinaldo Pellicano, Mario Rizzetto, Department of Gastroenterology and Digestive Endoscopy, "Città della Salute e della Scienza", University of Turin, 10126 Turin, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: De Angelis
authors.affiliation: Claudio De Angelis, Milena Marietti, Mauro Bruno, Rinaldo Pellicano, Mario Rizzetto, Department of Gastroenterology and Digestive Endoscopy, "Città della Salute e della Scienza", University of Turin, 10126 Turin, Italy.
authors.forename: Milena
authors.initials: M
authors.lastname: Marietti
authors.affiliation: Claudio De Angelis, Milena Marietti, Mauro Bruno, Rinaldo Pellicano, Mario Rizzetto, Department of Gastroenterology and Digestive Endoscopy, "Città della Salute e della Scienza", University of Turin, 10126 Turin, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Bruno
authors.affiliation: Claudio De Angelis, Milena Marietti, Mauro Bruno, Rinaldo Pellicano, Mario Rizzetto, Department of Gastroenterology and Digestive Endoscopy, "Città della Salute e della Scienza", University of Turin, 10126 Turin, Italy.
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Pellicano
authors.affiliation: Claudio De Angelis, Milena Marietti, Mauro Bruno, Rinaldo Pellicano, Mario Rizzetto, Department of Gastroenterology and Digestive Endoscopy, "Città della Salute e della Scienza", University of Turin, 10126 Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Rizzetto
keywords: Endoscopic ultrasound; Normal liver enzymes; Unexplained common bile duct dilatation