Author/Editor     Dajčman, Davorin; Skalicky, Marjan; Tošovič, Zdravko
Title     Primerjava sodobnih diagnostičnih metod žolčnih kamnov v skupnem žolčnem vodu in smernice njihove stopenjske uporabe
Translated title     Comparison of the modern diagnostic methods for gallstones disease in common bile duct and guidelines for their graded use
Type     članek
Source     Zdrav Vestn
Vol. and No.     Letnik 73, št. 4
Publication year     2004
Volume     str. 191-5
Language     slo
Abstract     Background. The differential diagnosis of biliary diseases remains a challenge. Endoscopic retrograde cholangiopancreatography (ERCP) was the gold standard for pancreaticobiliary evaluation but it is associated with complications. Less invasive diagnostic alternatives with similar capabilities may be cost-effective, particularly in situations involving low prevalence of disease. EUS is a modality for bile duct visualization that could lower costs and prevent ERCP-related complications. EUS, an accurate and minimally invasive modality, may limit ERCP to therapeutic use in biliary pancreatitis. With recent technological advances, however, the role of ERCP has become more therapy oriented also for other biliary diseases. EUS is recommended if ultrasonography have failed to detect common bile duct (CBD) stones. Recent studies demonstrate that magnetic resonance cholangiopancreatography (MRCP) is comparable to ERCP in the detection of choledocholithyasis. Conclusions. The aim of this article is to compare the performance of endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP) with ERCP and represent our diagnostic and therapeutic guidelines in the patients with suspected common bile duct stones.
Summary     Izhodišča. Bolezni žolčnih poti in njihovo prepoznavanje so velik izziv. Do nedavnega je bila endoskopska retrogradna holangiopankreatografija (ERCP) zlati standard za odkrivanje bolezni v tem področju kljub sorazmerno velikemu tveganju za nastanek zapletov, zaradi česar so preiskave z manjšo invazivnostjo in podobnimi zmožnostmi bolj ekonomične. Endoskopski ultrazvok (EUZ) je bistveno bolj varna preiskava za prikaz zunajjetrnih žolčnih poti, zmanjšuje nevarnost zapletov po ERCP in posledično stroške zdravljenja. Pri bolnikih z vnetjem trebušne slinavke zaradi žolčnih kamnov EUZ omogoča omejitev uporabe ERCP zgolj v terapevtske posege. Z razvojem EUZ se uporaba ERCP omejuje tudi pri drugih boleznih žolčnih poti. EUZ je priporočena preiskava pri bolnikih, kadar z navadnim ultrazvokom ni možno potrditi prisotnosti žolčnih kamnov v skupnem žolčnem vodu. Številne šudije potrjujejo primerljivost magnetnoresonančne holangiopankreatografije (MRCP) z ERCP v diagnostiki žolčnih kamnov v skupnem žolčnem vodu. Zaključki. V članku želimo prikazati primerjavo uporabnosti endoskopskega ultrazvoka in magnetnoresonančne holangiopankreatografije z ERCP v diagnostiki žolčnih kamnov v skupnem žolčnem vodu in predstaviti naš predlog smernic za njihovo potrjevanje in zdravljenje.
Descriptors     COMMON BILE DUCT CALCULI
CHOLANGIOPANCREATOGRAPHY, ENDOSCOPIC RETROGRADE
ENDOSONOGRAPHY
MAGNETIC RESONANCE IMAGING
PRACTICE GUIDELINES