Predictive factors in the differential diagnosis of benign and malignant causes in patients undergoing endoscopic retrograde cholangiopancreatography for extrahepatic cholestasis

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dc.authoridErdogan, Mumin Alper/0000-0003-0048-444X
dc.authoridYildirim, Oguzhan/0000-0001-8254-0104
dc.authorwosidErdogan, Mumin Alper/AAR-3140-2021
dc.authorwosidYildirim, Oguzhan/ABI-8174-2020
dc.contributor.authorYildirim, O.
dc.contributor.authorErdogan, M. A.
dc.date.accessioned2024-08-04T21:00:12Z
dc.date.available2024-08-04T21:00:12Z
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 mu mol/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 mu mol/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 cholestasisen_US
dc.identifier.endpage11463en_US
dc.identifier.issn1128-3602
dc.identifier.issue23en_US
dc.identifier.pmid38095393en_US
dc.identifier.startpage11457en_US
dc.identifier.urihttps://hdl.handle.net/11616/103887
dc.identifier.volume27en_US
dc.identifier.wosWOS:001159390600018en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherVerduci Publisheren_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.subjectEndoscopic retrograde cholangiopancreatography (ERCP)en_US
dc.subjectCholestasisen_US
dc.subjectPredictiveen_US
dc.subjectBiliary strictureen_US
dc.subjectDifferential diagnosisen_US
dc.titlePredictive factors in the differential diagnosis of benign and malignant causes in patients undergoing endoscopic retrograde cholangiopancreatography for extrahepatic cholestasisen_US
dc.typeArticleen_US

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