| Theme | Treatment of Choledocholithiasis | |
|---|---|---|
| Title | Imaging Based Diagnosis of Common Bile Duct Stone | |
| Publish Date | 2017/01 | |
| Author | Akio Katanuma | Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author | Toshifumi Kim | Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author | Kei Yane | Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author | Kazumasa Nagai | Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author | Kuniyuki Takahashi | Center for Gastroenterology, Teine‒Keijinkai Hospital |
| Author | Hiroyuki Maguchi | Center for Gastroenterology, Teine‒Keijinkai Hospital |
| [ Summary ] | Clinical symptoms of bile duct stones include fever, abdominal pain, jaundice ; however, some cases are asymptomatic. Since acute cholangitis caused by choledocholithiasis can be life-threatening, accurate diagnosis and early stone removal are necessary. Imaging modalities used in bile duct stone diagnosis include US, CT, MRCP, ERCP, EUS, and IDUS. US (ultrasonograpy) is the safest and least invasive procedure ; however, stone detection rate with US is not very high. CT is superior to US in terms of stone detection rate ; however, CT may fail in detecting small-sized stones. MRCP and EUS are superior to other imaging modalities and EUS has a high diagnostic accuracy with regard to bile duct stones. In addition, it is useful for detecting small stones that cannot be detected by CT or MRCP. However, use of ERCP alone is decreasing owing to complications such as post-ERCP pancreatitis. IDUS (intraductal ultrasonography) is reported as a useful method for diagnosis of bile duct stones that cannot be detected using cholangiography. | |