Common Bile Duct Dilation

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To determine the role of EUS in the exclusion of benign and malignant pathology that might require further intervention in the presence of asymptomatic common bile duct dilation (CBD), the yield of EUS evaluation for this indication was evaluated through systematic review, attempting to appraise the yield of EUS interpretation in asymptomatic patients with radiologic evidence of that dilation.

A protocolled search (PROSPERO: CRD42020193428) extracted original studies from the Cochrane Library, Ovid Embase, Google Scholar, Ovid Medline, PubMed, Scopus, and Web of Science Core Collection, that described diagnostic yield of EUS among asymptomatic patients with biliary dilation. Cumulative EUS diagnostic yield was calculated through meta-analysis of proportions, using inverse variance methods and a random-effects model. 

Of 2,616 studies, 8 delineated the EUS yield among 224 asymptomatic patients. The cumulative yield of EUS for any pathology was

11.2%. The EUS yield for benign etiologies was 9.2%, of which choledocholithiasis comprised 3.4% and malignant etiologies 0.5% of cases. It was concluded that EUS in patients with asymptomatic CBD dilation does yield findings of choledocholithiasis and malignancy, albeit at low rates. Clinical decision-making plays a role in its application.

Choda, A., Dawod, S., Grimshaw, A., et al.  “Evaluation of Diagnostic Yield of EUS Among Patients with Asymptomatic Common Bile Duct Dilation:  Systematic Review and Meta-Analysis.”  Gastrointestinal Endoscopy, Vol. 94, No. 5:  2021, pp. 890-901.

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