New possibilities in the ultrasound diagnostics of the bile duct

Ultrasonography (US) of the bile duct is part of every abdominal US examination. Nevertheless, even now, some controversial problems exist in the interpretation of the results (postcolecystectomy syndrome, etc.). Beside the so called „routine“ bile duct US, frequently the main indication of the abdominal US scanning is the suggestion of some bile duct disease, not rarely urgently.

Recently, beside the commonly used transabdominal US, new methods were developed for the more effective detection of bile duct lesions, namely, the endoscopic and intraductal US (EUS and IDUS, respectively). Despite the financial problems, it is important to take into consideration these new methods and outline their technical bases, as well as some clinical application of them.

These procedures are able to detect the alterations of the distal part of the common bile duct (CBD), of the Vater papilla and its surroundings with high effectivity and reliability even in those cases, when ERCP is technically unsuccessful; to help invasive therapeutic interventions, thus may replace other, more invasive methods, such as ERCP, PTBD, etc. Hopefully, they will be useful tools in the hand of future gastroenterologists.