Added Value of Hepatic Enzymes on Endoscopic Ultrasound Assessment of Jaundice Caused by Biliary Tumors

Cholangiocarcinoma are rare tumors with different imaging presentations, but the diagnosis is difficult to be made even with CT scan or MRI. Endoscopic ultrasound (EUS) can offer supplementary information in detection and staging, but little is known if increased hepatic enzymes can add something for the diagnosis. Aim: To determine the accuracy of EUS in staging of cholangiocarcinoma and whether high level of transaminases helps in staging. Methods: This is a retrospective study. It included patients with extrahepatic cholangiocarcinoma staged by using EUS, confirmed by histology and surgical staging subsequently. T and N stage established by EUS were compared with surgical stage. Elevated transaminases were assessed for each stage. Results: 54 patients with jaundice of unknown origin and EUS diagnosis of cholangiocarcinoma were included, but surgical histology was positive in only 23 patients. T staging during EUS comprised 4 tumors T1 (17%), 3 T2 (13%), 13 T3 (57%) and 3 tumors T4 (13%). The global accuracy for T stage was 91,3%. Sensitivity and specificity of EUS for tumors T1-T2 was 71,4% and 100% respectively, for T3 was 100% and 80%, and for T4 it was 100% and 100%. Elevated transaminases did not differ between stages. Conclusion: EUS has a good accuracy in staging of cholangiocarcinoma, but the level of transaminases has no supplementary value.