Role of EUS in suspected choledocholithiasis

What is the role of EUS in suspected choledocholithiasis? 

This depends on the probability of choledocholithiasis being present based on clinical and imaging findings.

In patients with high probability of choledocholithiasis (total bilirubin > 4 mg/dL or common bile duct (CBD) stone seen on radiologic imaging, or both dilated CBD with bilirubin 1.8-4 mg/dL), ERCP should be performed without further testing, whereas patients with low probability of stones may be managed conservatively.

EUS is indicated in patients with intermediate probability of choledocholithiasis (abnormal liver function tests other than bilirubin, clinical gallstone pancreatitis, age > 55 years).


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