Title : Contribution of echo-endoscopy in biliary tract dilatations without obvious obstacle on imaging
Abstract:
Introduction:
Echo-endoscopy is an essential technic in the exploration of anomalies of the bilio-pancreatic tract. However, it causes problems of availability and expertise of operators. The aim of our study is to specify the place of echo-endoscopy in the etiological diagnosis of biliary tract dilatations when conventional imaging is not contributive.
Aims & Methods:
This is a retrospective descriptive and analytical study conducted between January 2008 and March 2021, including 51 patients with intra and/or extra hepatic bile duct dilatation on imaging without obvious obstruction. For cystic dilatation of the main bile duct, the TODANI classification was taken into consideration. Statistical analysis was performed by SPSS software version 22.0.
Results:
Fifty-one (51) patients were collected, which represents about 11% of all indications for echo-endoscopy in our department. The average age of our patients was 60± 12.10 years, with extremes ranging from 28 to 80 years, our series was characterized by a clear female predominance at 78%, is a sex ratio M/F: 0.28.
The echo-endoscopy confirmed the dilatation in 56.9% (n=29) of our patients, and an bi-canal dilatation was found in 5.9% (n=3) of patients.
The exploration by echo-endoscopy revealed in 43.1% (n=22) of the cases a cystic dilatation of the bile ducts of type I according to the classification of TODANI, a lithiasis of the main biliary duct in 5.9% (n=3) of the cases, an ampulloma in 3.9% of the patients (n=2), pancreatic head cancer was suspected during echo-endoscopy and then histologically was confirmed in 2% of patients (n=1), and biliary tract papillomatosis was diagnosed in 2% of patients (n=1). Nevertheless, echo-endoscopy allowed us to rule out biliary tract dilatation in 43.1% (n=22) of our patients.
Conclusion:
Our study showed that echo-endoscopy plays a key role in the diagnostic approach to dilated bile ducts when imaging is inconclusive.
