What is the role of ultrasonography in the workup of postcholecystectomy syndrome (PCS)?

Updated: Nov 28, 2018
  • Author: Steen W Jensen, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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Answer

An ultrasonographic study is almost always performed; it is a quick, noninvasive, and relatively inexpensive way to evaluate the liver, biliary tract, pancreas, and surrounding areas. A 10- to 12-mm dilation of the common bile duct (CBD) is commonly observed. Dilation exceeding 12 mm is often diagnostic of distal obstruction, such as a retained stone, CBD stricture, or ampullary stenosis.

In a study of 80 patients with PCS, Filip et al concluded that endoscopic ultrasonography (EUS) was a valuable tool for determining which patients require endoscopic retrograde cholangiopancreatography (ERCP). [13] The sensitivity and specificity of EUS were found to be 96.2% and 88.9%, respectively, in a subset of 53 patients who were ultimately diagnosed with biliary or pancreatic disease. The investigators found that the use of EUS helped to reduce the number of patients receiving ERCP by 51%.


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