of benign and malignant causes in patients undergoing endoscopic retrograde cholangiopancreatography for extrahepatic cholestasis

Basit Öğe Kaydı
dc.authorscopusid55445082300
dc.authorscopusid59023447300
dc.contributor.authorYildirim O.
dc.contributor.authorErdogan M.A.
dc.date.accessioned2024-08-04T20:00:48Z
dc.date.available2024-08-04T20:00:48Z
dc.date.issued2023
dc.departmentİnönü Üniversitesien_US
dc.description.abstractOBJECTIVE: Diagnosing benign vs. malignant extrahepatic cholestasis is challenging despite the currently available advanced imaging and endoscopic techniques. This study aims to determine the predictive accuracy of initial biochemical data and bile duct dilatation findings in transabdominal ultrasound (US) to differentiate between benign and malignant disease in patients with extrahepatic cholestasis. PATIENTS AND METHODS: We reviewed the case records of 814 patients who had undergone endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (in cases of unsuccessful ERCP) for extrahepatic cholestasis. The etiology of biliary obstruction was determined based on ERCP, endoscopic ultrasonography, radiology, cytology, biopsy, and/or clinical follow-up at one year. The patients were divided into benign and malignant groups according to the underlying etiology of biliary obstruction. A complete biochemical profile, transabdominal ultrasonography at presentation, and other demographic data were recorded. RESULTS: Alkaline phosphatase (p = 0.002), aspartate aminotransferase (p = 0.038), and bilirubin levels were significantly higher in malignant patients. The mean age of patients with malignancy was 69.5 years, vs. 60.6 years in benign patients (p < 0.001). The likelihood of malignancy increased with the increased bilirubin levels (> 200 µmol/l: 30.0% sensitivity, 97.6% specificity). The total bilirubin level predicting malignancy as the best cut-off value was 111 mmol/L with optimum sensitivity and specificity (61.8% and 83.8%, respectively) and area under the curve = 0.756, (p < 0.001). Intrahepatic bile duct (IHBD) dilatation was significantly higher in malignant patients (p < 0.001). CONCLUSIONS: A serum bilirubin level of 111 µmol/L or higher and the detection of IHBD dilatation on abdominal ultrasonography are important predictors in the differential diagnosis of benign and malignant causes of extrahepatic cholestasis. © 2023 Verduci Editore s.r.l. All rights reserved.en_US
dc.identifier.doi10.26355/eurrev_202312_34584
dc.identifier.endpage11463en_US
dc.identifier.issn1128-3602
dc.identifier.issue23en_US
dc.identifier.pmid38095393en_US
dc.identifier.scopus2-s2.0-85179767644en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpage11457en_US
dc.identifier.urihttps://doi.org/10.26355/eurrev_202312_34584
dc.identifier.urihttps://hdl.handle.net/11616/91019
dc.identifier.volume27en_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherVerduci Editore s.r.len_US
dc.relation.ispartofEuropean Review for Medical and Pharmacological Sciencesen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.subjectBiliary strictureen_US
dc.subjectCholestasisen_US
dc.subjectDifferential diagnosisen_US
dc.subjectEndoscopic retrograde cholangiopancreatography (ERCP)en_US
dc.subjectPredictiveen_US
dc.titleof benign and malignant causes in patients undergoing endoscopic retrograde cholangiopancreatography for extrahepatic cholestasisen_US
dc.typeArticleen_US

Dosyalar

Koleksiyon

Scopus İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayın Koleksiyonu