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Magnetic resonance cholangiopancreatography versus endoscopic ultrasound for diagnosis of choledocholithiasis: an updated systematic review and meta-analysis

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Abstract

Introduction

Both endoscopic ultrasound (EUS) and magnetic resonance cholangiopancreatography (MRCP) are used for the diagnosis of choledocholithiasis (CDL). Previous studies have shown conflicting results regarding the optimal diagnostic strategy for suspected CDL; hence, this meta-analysis was conducted.

Methods

A comprehensive search of literature from 1990 till April 2022 was done of three databases for studies comparing EUS and MRCP to diagnose CDL.

Results

A total of 12 studies were identified. The pooled sensitivity and specificity for EUS were 0.96 [95% confidence interval (CI) 0.92–0.98], and 0.92 (95% CI 0.85–0.96), respectively. The pooled sensitivity and specificity for MRCP were 0.85 (95% CI 0.78–0.90) and 0.90 (95% CI 0.79–0.96), respectively. EUS had a higher relative sensitivity [Relative risk (RR) 1.12, 95% CI 1.05–1.19], a higher diagnostic accuracy (Odds ratio 1.98, 95% CI 1.35–2.90) but comparable specificity (RR 1.02, 95% CI 0.96–1.08) with MRCP.

Conclusion

There is little difference concerning specificity, although EUS likely provides a higher sensitivity and accuracy for diagnosing CDL, compared to MRCP.

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Authors and Affiliations

  1. Institute of Gastrosciences and Liver, Apollo Multispecialty Hospital, Kolkata, India

    Shivaraj Afzalpurkar

  2. Department of Gastroenterology, Nizam’s Institute of Medical Sciences, Hyderabad, India

    Suprabhat Giri

  3. Department of Gastroenterology, Gastrocare, Liver & Digestive Disease Center, Bhopal, India

    Sunil Kasturi

  4. Department of General Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India

    Sushrut Ingawale

  5. Department of Digestive Diseases and Clinical Nutrition, Tata Memorial Hospital, Homi Bhabha National Institute, Parel, Mumbai, 400012, Maharashtra, India

    Sridhar Sundaram

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Contributions

SA, SG, SK, SI, and SS contributed to conception of the work, the acquisition, analysis, or interpretation of data for the work, drafting the work, critical revision, and final approval of the version. SA, SG, SK, SI, and SS agree to be accountable for all aspects of the work.

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Correspondence to Sridhar Sundaram.

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Disclosures

Dr. Shivraj Afzalpurkar, Dr. Suprabhat Giri, Dr. Sunil Kasturi, Dr. Sushrut Ingawale and Dr. Sridhar Sundaram have no financial relationships or conflicts of interest.

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Afzalpurkar, S., Giri, S., Kasturi, S. et al. Magnetic resonance cholangiopancreatography versus endoscopic ultrasound for diagnosis of choledocholithiasis: an updated systematic review and meta-analysis. Surg Endosc 37, 2566–2573 (2023). https://doi.org/10.1007/s00464-022-09744-3

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