Parasites and Biliary stones

Choledocholithiasis ٧٦
and ERCP (Sugiyama and Atomi, 1997 and Amouyal et al., 1994).
Although with a specificity of approximately 95%, TUS remains an
extremely useful test if CBDS are detected (Sugiyama and Atomi,
1997). A negative TUS in a patient with suspected Choledocholithiasis
does not rule out CBDS (Gross et al., 1983).
Endoscopic ultrasonography (EUS): EUS is an accurate test for
detection of CBDS, with a sensitivity range between 94% and 98%
(Buscarini et al., 2003 and Canto et al., 1998).
Computed tomography scan: Conventional computed tomography (CT)
studies have found sensitivities between 70% and 90% in the detection of
choledocholithiasis (Mitchell and Clark, 1984). The use of unenhanced
helical CT for detection of choledocholithiasis has similar sensitivities of
67%-88% (Jimenez et al., 2001). Oral enhanced CT cholangiography has
an increased sensitivity of 92% (Soto et al., 2000).
Magnetic resonance cholangiopancreatography (MRCP): Magnetic
Resonance Cholangiography (MRCP) has become an accepted method of
imaging the bile duct with a high sensitivity and specificity for
choledocholithiasis.The accuracy rates of detection of choledocholithiasis
comparable between EUS and MRCP (accuracy rate 93% and 91%,
respectively) (Ainsworth et al., 2003). Laokpessi et al. (2001) found
that both MRCP and ERCP comparable in detection of CBDS (sensitivity
and specificity 93% and 100%; 94% and 100%, respectively).
MRCP has emerged as an accurate, non-invasive diagnostic
modality for investigating the biliary and pancreatic ducts (Hallal et al.,
2005), and has been recommended in some circles as the preoperative
procedure of choice for the detection of CBD stones (Peng et al., 2005;
Taylor et al., 2002 and Topal et al., 2003). MRCP provides excellent
anatomic detail of the biliary tract and has a sensitivity of 81%-100% and