Endoscopy 2005; 37 - 84
DOI: 10.1055/s-2005-868607

CBD stones. Is ultrasonography enough?

C Mehta 1, C Rodgers 1, NI McDougall 1, SG Jacob 1, M Nelson 1
  • 1Department of Surgery, Department of Gastroenterology and Department of Radiology Antrim Area Hospital, County Antrim, Northern Ireland

Aims: The aim of the study was to analyse efficacy and accuracy of ultrasonography in diagnosis of CBD stones during a period in which MRCP was not easily available.

Methods: Over a 3-year period 270 patients were diagnosed with CBD stones on ERCP. 115 of them were studied retrospectively and their ultrasound scans were analysed. Referrals from other hospitals, patients with gallbladder surgery, previous ERCP were excluded.

Results: CBD stones were demonstrated on ultrasonography in 31 (27 per cent) of 115 patients.

Dilatation of the CBD was diagnosed on ultrasonography in 68 (60 per cent) of 115 patients.

Stones were demonstrated in the dilated CBD on ultrasonography in 40 (60 per cent) of 68 patients.

CBD stones were missed on ultrasonography in 28 (40 per cent) of 68 patients with dilated CBD.

Stones were demonstrated in non-dilated CBD on ultrasonography in 3 (6 per cent) of 47 patients.

CBD stones were missed in non-dilated CBD on ultrasonography in 44 (94 per cent) of 47 patients.

Conclusion: This study demonstrates that in cases with high index of clinical suspicion of CBD stones a negative ultrasonography is not enough and these patients need further investigations i.e. MRCP or Spiral CT.