title: Reliability of endoscopic ultrasound in predicting the number and size of common bile duct stones before endoscopic retrograde cholangiopancreatography.
abstract: BACKGROUND
  Endoscopic ultrasound (EUS) is accurate for the diagnosis of choledocholithiasis; however, data are lacking regarding the prediction of stone number and size.
  
  
  OBJECTIVE
  To evaluate the concordance between EUS and endoscopic retrograde cholangiopancreatography (ERCP) in stone number and size assessment.
  
  
  METHODS
  We performed a retrospective analysis of consecutive patients undergoing ERCP due to detection of choledocholithiasis by EUS. Concordance between EUS and ERCP was defined as difference in stone diameter <30% and perfect match in stone number.
  
  
  RESULTS
  Among 116 patients, 25% had sludge, 37.9% had single and 37.1% had multiple stones. Overall concordance was 62.9%. Sludge was correctly assessed in 85.7%, single stone in 81.3% and multiple stones in 45.1% (P=0.0001). EUS was accurate in 78.8% of patients who underwent both procedures in the same session, but only in 61.9% in those who underwent ERCP within 1 week. Multivariate analysis identified the single-session approach (odds ratio 2.894; P=0.035) and multiple stones (odds ratio 0.244; P=0.001) as independent predictors of concordance.
  
  
  CONCLUSIONS
  Concordance between EUS and ERCP was correlated to the single session approach and inversely correlated to the presence of multiple stones. EUS may predict potentially difficult ERCP allowing to plan the best treatment strategy.
authors.affiliation: Gastrointestinal Unit, Department of Medical and Surgical Sciences, University of Bologna/Hospital of Imola, Italy. Electronic address: pietro.fusaroli@unibo.it.
authors.forename: Pietro
authors.initials: P
authors.lastname: Fusaroli
authors.affiliation: Gastrointestinal Unit, Department of Medical and Surgical Sciences, University of Bologna/Hospital of Imola, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Lisotti
authors.affiliation: Gastrointestinal Unit, Department of Medical and Surgical Sciences, University of Bologna/Hospital of Imola, Italy.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Syguda
authors.affiliation: Gastrointestinal Unit, Department of Medical and Surgical Sciences, University of Bologna/Hospital of Imola, Italy.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: D'Ercole
authors.affiliation: Gastrointestinal Unit, A.O. Ospedali Riuniti Marche Nord, Pesaro, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Maimone
authors.affiliation: Gastrointestinal Unit, Maggiore Hospital, Bologna, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Fabbri
authors.affiliation: Gastrointestinal Unit, Maggiore Hospital, Bologna, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cennamo
authors.affiliation: Gastrointestinal Unit, Santa Maria Nuova Hospital, Reggio Emilia, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Cecinato
authors.affiliation: Gastrointestinal Unit, Sant'Orsola-Malpighi Hospital, Bologna, Italy.
authors.forename: Giulio
authors.initials: G
authors.lastname: Cariani
authors.affiliation: Gastrointestinal Unit, Department of Medical and Surgical Sciences, University of Bologna/Hospital of Imola, Italy.
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Caletti
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003135:Common Bile Duct / Q000000981:diagnostic imaging*; D019160:Endosonography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: Choledocholithiasis; ERCP; EUS; Endosonography