Multidetector computed tomography evaluation of obstructive jaundice: a cross-sectional study from a tertiary hospital of Nepal

Abstract

Background: The utilization of advanced multidetector computed tomography (MDCT) technology along with postprocessing reconstruction techniques has significantly enhanced the clarity of visualization of the hepato-biliary tree. Therefore, this study was conducted to evaluate the diagnostic statistics of MDCT and its associated features in the evaluation of obstructive jaundice, with respect to surgical or histopathological diagnoses. Methods and methodology: The authors conducted a cross-sectional study among 30 participants with obstructive jaundice using purposive sampling. The authors calculated the diagnostic statistics of non-neoplastic and neoplastic types, along with specific etiologies of obstructive jaundice identified through MDCT using a statistical package for social sciences (SPSS) v21 and MedCalc v12.3.0. The ethical clearance was obtained from the institutional review committee of BPKIHS, Nepal (Ref no: Acd/291/075/076-IRC). Results: The sensitivity and the negative predictive value of MDCT for non-neoplastic cause to detect obstructive jaundice were 100% (95% CI: 79.41–100.00) and 100% (95% CI: 75.29–100.00), while the specificity and the positive predictive value for neoplastic cause to detect obstructive jaundice were 100% (95% CI: 79.41–100.00) and 100% (95% CI: 75.29–100.00), respectively. Similarly, the accuracy for either non-neoplastic or neoplastic cause was 96.67% (95% CI: 82.78–99.92). The most common cause of obstructive jaundice was choledocholithiasis (33.34%) followed by cholangiocarcinoma (20%), ampullary carcinoma (13.33%), and choledochal cyst (13.33%). The diagnostic accuracy of the individual etiology of common causes of obstructive jaundice ranged from 82.78 to 100%. Biliary obstruction was most frequently observed in the periampullary region (83.33%), followed by the proximal common bile duct (6.67%), hilar region (6.67%), and intrahepatic region (3.33%). Conclusion: The MDCT could serve as the initial and time-efficient excellent imaging modality for diagnosing various causes of obstructive jaundice with greater accuracy. It can differentiate non-neoplastic from neoplastic causes of obstructive jaundice.