The Role of Endoscopic Ultrasound in Evaluation of Patients With Indefinite Cause of Bile Duct Dilatation

NCT ID: NCT05475964

Last Updated: 2022-07-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-09-09

Study Completion Date

2025-08-31

Brief Summary

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In the era of diagnostic imaging advances, Bile Duct Dilatation becomes a common incidental finding in patients present with either gastrointestinal symptoms or undergone the imaging study for any other complaints. Endoscopic ultrasound enables high resolution views of the biliary system, so it can help detection of different pathologies which cause bile duct dilatation and difficult to be detected by other imaging studies.

Detailed Description

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The normal diameter of the common bile duct (CBD) varies by age, imaging modality, prior cholecystectomy, and previous biliary obstruction, but 7 mm or more is considered widely accepted cutoff for biliary dilatation, and 10 mm or more among post-cholecystectomy patients.

BDD with unclear etiology detected on trans abdominal ultrasound (TUS), computed tomography (CT), or magnetic resonance cholangiopancreatography (MRCP). Although, these imaging techniques have a good sensitivity and specificity in detecting biliary tract diseases, limitations are still present in the detection of intraductal small stones, ampullary lesions and small masses.

As regard TUS, overlying bowel gas and operator-dependence, often harshen an adequate visualization of the biliary duct to identify the etiology, and CT could miss tumors less than 2 cm in size, while the sensitivity of MRCP decreases in stones 3 mm or less in size.

Endoscopic ultrasound (EUS) enables high resolution views of the biliary tree as it joins the pancreatic duct and duodenum, so it helps detection of biliary pathologies difficult to be diagnosed by external radiograph. In addition, EUS is less invasive than the competitive endoscopic retrograde cholangiopancreatography (ERCP) as a diagnostic modality and it avoids the patients the post-ERCP pancreatitis which is a very common complication, as well as providing a unique opportunity of tissue sampling and staging of any detected malignant lesions.

Previously, EUS has proven it's high ability to the detect the stones in the extrahepatic ducts with a sensitivity as high as of 94% and specificity of 95%.

Besides, it's well performance in the evaluation of biliary strictures with a sensitivity 80%, and a specificity of 97% in detecting malignant biliary strictures.

When it comes to ampullary and pancreatic lesions, direct endoscopic visualization with a side-viewing endoscope can effectively evaluate the periampullary area and detect ampullary mass and diverticulum, as well examine the pancreas for chronic pancreatitis, masses, and cysts.

Conditions

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Bile Duct Diseases

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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patients with undiagnosed bile duct dilatation

patients with bile duct dilation detected by imaging studies without revealing definite cause of obstruction

Group Type OTHER

Endoscopic ultrasound

Intervention Type DEVICE

Endoscopic ultrasound and biopsy intake of suspected lesions

Interventions

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Endoscopic ultrasound

Endoscopic ultrasound and biopsy intake of suspected lesions

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Prior inconclusive imaging studies of bile duct dilation.
2. Common bile duct diameter of \>10 mm with prior cholecystectomy or \>7 mm without

Exclusion Criteria

Definite cause of obstruction stone, stricture, or mass on imaging studies (TUS, CT, MRCP or ERCP).

\-
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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HMHamed

OTHER

Sponsor Role lead

Responsible Party

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HMHamed

Assistant lecturer of tropical medicine and gastroenterology

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Hager Hamed, Master

Role: PRINCIPAL_INVESTIGATOR

Assiut University

Locations

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AssiutU

Asyut, , Egypt

Site Status

Countries

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Egypt

Central Contacts

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hager Hamed, Master

Role: CONTACT

01090377530

Hamed

Role: CONTACT

Other Identifiers

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EUS in biliary dilatation

Identifier Type: -

Identifier Source: org_study_id

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