Clinical Endoscopy

Usefulness of Endoscopic Transpapillary Tissue Sampling for Malignant Biliary Strictures and Predictive Factors of Diagnostic Accuracy: Hiroki Tanaka, Shimpei Matsusaki, Youichirou Baba, Yoshiaki Isono, Tomohiro Sase, Hiroshi Okano, Tomonori Saito, Katsumi Mukai, Tetsuya Murata, Hiroki Taoka; Clin Endosc 2018;51(2):174-180. Published online August 31, 2017; DOI: https://doi.org/10.5946/ce.2017.082

Background
/Aims: It is sometimes difficult to distinguish between malignant and benign biliary strictures using imaging studies alone, and pathological diagnosis is necessary. The aim of this study was to determine the usefulness of endoscopic transpapillary tissue sampling and factors predictive of diagnostic accuracy.
Methods
From April 2008 to December 2014, 136 patients underwent endoscopic transpapillary tissue sampling for malignant biliary strictures. The cytological and histological findings were reported as negative, suspicious, or positive. Suspicious and positive findings were defined as pathologically positive.
Results
The sensitivity was 65.0% for forceps biopsy, 49.5% for brush cytology, 46.2% for bile aspiration cytology, and 21.9% for endoscopic nasobiliary drainage cytology. The combination of these procedures improved the sensitivity (72.8%). Endoscopic transpapillary tissue sampling was more sensitive for lesions of biliary origin (91.4%) than for extrabiliary lesions (66.3%). In surgical cases, the sensitivity for tumors with an infiltrative growth pattern (53.3%) was significantly lower than for a tumor with an expanding or intermediate growth pattern (87.5%).
Conclusions
Combining procedures can improve diagnostic accuracy. It may be possible to predict the sensitivity of endoscopic transpapillary tissue sampling by evaluating the etiology and tumor growth pattern using preoperative imaging studies.

Citations

Citations to this article as recorded by

A new tool for bile duct tissue sampling: ex vivo clinical evaluation of intraductal cryobiopsy for cholangioscopy
Lukas Wirsing, Walter Linzenbold, Simon U. Jaeger, Phillip Stahl, German Ott, Tobias Leibold, Markus Enderle, Jörg Albert, Jan Peveling-Oberhag
Endoscopy International Open.2022; 10(06): E809. CrossRef
Increased accuracy of FNA-based cytological diagnosis of pancreatic lesions by use of an ethanol-based fixative system: A STROBE compliant study
Martin Bürger, Antje Heidrich, Iver Petersen, Andreas Stallmach, Carsten Schmidt
Medicine.2022; 101(36): e30449. CrossRef
Comparison of the Diagnostic Performance of Novel Slim Biopsy Forceps with Conventional Biopsy Forceps for Biliary Stricture: A Multicenter Retrospective Study
Eun Suk Jung, Se Woo Park, Jung Hee Kim, Jang Han Jung, Min Jae Yang, Da Hae Park
Journal of Personalized Medicine.2021; 11(1): 55. CrossRef
Factors affecting the diagnostic yield of endoscopic transpapillary forceps biopsy in patients with malignant biliary strictures
Min Jae Yang, Jae Chul Hwang, Dakeun Lee, Young Bae Kim, Byung Moo Yoo, Jin Hong Kim
Journal of Gastroenterology and Hepatology.2021; 36(8): 2324. CrossRef
Tissue sampling for biliary strictures using novel elbow biopsy forceps
Huahui Zhang, Chunyan Huo, Yongxin Guo, Keyuan Zhu, Fengdong Li, Jin Huang
Scientific Reports.2021;[Epub] CrossRef
Tips and tricks for the diagnosis and management of biliary stenosis-state of the art review
Giovanna Del Vecchio Blanco, Michelangela Mossa, Edoardo Troncone, Renato Argirò, Andrea Anderloni, Alessandro Repici, Omero Alessandro Paoluzi, Giovanni Monteleone
World Journal of Gastrointestinal Endoscopy.2021; 13(10): 473. CrossRef
Ethanol-based fixation is superior to conventional brush cytology in the evaluation of indeterminate biliary strictures by endoscopic retrograde cholangiography
Martin Bürger, Antje Besser, Iver Petersen, Andreas Stallmach, Carsten Schmidt
Medicine.2020; 99(5): e18920. CrossRef
Endoscopic retrograde cholangiopancreatography guided interventions in the management of pancreatic cancer
Muhammad Nadeem Yousaf, Hamid Ehsan, Ahsan Wahab, Ahmad Muneeb, Fizah S Chaudhary, Richard Williams, Christopher J Haas
World Journal of Gastrointestinal Endoscopy.2020; 12(10): 323. CrossRef
Percutaneous transhepatic cholangiobiopsy
Thiago Franchi Nunes, Tiago Kojun Tibana, Rômulo Florêncio Tristão Santos, Bernardo Bacelar de Faria, Edson Marchiori
Radiologia Brasileira.2019; 52(1): 41. CrossRef
Factors Associated with Malignant Biliary Strictures in Patients with Atypical or Suspicious Cells on Brush Cytology
Ji Young Park, Tae Joo Jeon
Clinical Endoscopy.2019; 52(2): 168. CrossRef
Diagnosis of Malignant Biliary Stricture: More is Better
Hyun Jik Lee, Kwang Bum Cho
Clinical Endoscopy.2018; 51(2): 115. CrossRef

7,889 View
133 Download
12 Web of Science
11 Crossref

Endoscopic Management of Anastomotic Strictures after Liver Transplantation: Dong Wook Lee, Hyeong Ho Jo, Juveria Abdullah, Michel Kahaleh; Clin Endosc 2016;49(5):457-461. Published online September 30, 2016; DOI: https://doi.org/10.5946/ce.2016.130

Abstract PDF PubReader ePub

Endoscopic treatment of biliary strictures involving plastic stent placement has been used widely. The use of self-expandable metal stents (SEMSs) has been described for anastomotic strictures following liver transplantation (LT). This review aimed to assess and compare the efficacy of plastic stents with SEMS in LT patients. Information was retrieved regarding technical success, stricture resolution, the number of endoscopic retrograde cholangiography procedures, follow-up, immediate, and late complications. Eight studies involving plastic stents had a stricture resolution rate of 84.5%, with the rates ranging from 63% to 100%. These rates are comparable with the stricture resolution rate of 75% determined from six studies that involved 236 patients who received metal stents and the rates ranged from 53% to 81%. The observed success rate for metal stents used to manage post-LT anastomotic biliary strictures was below the reported rate for multiple plastic stents. Hence, the currently available metal stents should not be offered for the management of post-LT anastomotic biliary strictures.

Citations

Citations to this article as recorded by

Less is more: The use of single biodegradable stenting to treat biliary anastomotic strictures in pediatric liver transplantation
Jesús Quintero Bernabeu, Javier Juamperez Goñi, Maria Mercadal Hally, Cristina Padrós Fornieles, Mauricio Larrarte King, José Andrés Molino Gahete, Anna Coma Muñoz, Iratxe Diez Miranda, Mercedes Pérez Lafuente, Ramon Charco Torra, Ernest Hidalgo Llompart
Liver Transplantation.2025; 31(6): 793. CrossRef
Long-Term Results of Endoscopic Metal Stenting for Biliary Anastomotic Stricture after Liver Transplantation
Aymeric Becq, Alexis Laurent, Quentin De Roux, Cristiano Cremone, Hugo Rotkopf, Yann Le Baleur, Farida Mesli, Christophe Duvoux, Aurélien Amiot, Charlotte Gagniere, Nicolas Mongardon, Julien Calderaro, Daniele Sommacale, Alain Luciani, Iradj Sobhani
Journal of Clinical Medicine.2023; 12(4): 1453. CrossRef
Endoskopisches Management von Gallengangskomplikationen nach Leberchirurgie
Martha M. Kirstein, Torsten Voigtländer
Zentralblatt für Chirurgie - Zeitschrift für Allgemeine, Viszeral-, Thorax- und Gefäßchirurgie.2022; 147(04): 398. CrossRef
Intraductal fully covered self-expanding metal stents in the management of post-liver transplant anastomotic strictures: a UK wide experience
Wafaa Ahmed, Dave Kyle, Amardeep Khanna, John Devlin, David Reffitt, Zeino Zeino, George Webster, Simon Phillpotts, Robert Gordon, Gareth Corbett, William Gelson, Manu Nayar, Haider Khan, Matthew Cramp, Jonathan Potts, Waleed Fateen, Hamish Miller, Bharat
Therapeutic Advances in Gastroenterology.2022;[Epub] CrossRef
Incidents and risk factors of biliary complications after orthotropic liver transplantation
Samir Zeair, Robert Stasiuk, Labib Zair, Marta Wawrzynowicz-Syczewska, Anita Rybicka, Elżbieta Grochans, Arkadiusz Kazimierczak
Medicine.2021; 100(34): e26994. CrossRef
Biliary complications in recipients of living donor liver transplantation: A single-centre study
Reginia Nabil Guirguis, Ehab Hasan Nashaat, Azza Emam Yassin, Wesam Ahmed Ibrahim, Shereen A Saleh, Mohamed Bahaa, Mahmoud El-Meteini, Mohamed Fathy, Hany Mansour Dabbous, Iman Fawzy Montasser, Manar Salah, Ghada Abdelrahman Mohamed
World Journal of Hepatology.2021; 13(12): 2081. CrossRef
Management of Post-Transplant Anastomotic Stricture Using Self-Expandable Metal Stent
Dong Wook Lee, Kazuo Hara
Clinical Endoscopy.2020; 53(3): 261. CrossRef
A unique type of fully covered metal stent for the management of post liver transplant biliary anastomotic strictures
Ben Warner, Phillip Harrison, Muhammad Farman, John Devlin, David Reffitt, Yasser El-Sherif, Shirin E. Khorsandi, Andreas Prachalias, Miriam Cortes Cerisuelo, Krish Menon, Wayel Jassem, Parthi Srinivasan, Hector Vilca-Melendez, Michael Heneghan, Nigel Hea
BMC Gastroenterology.2020;[Epub] CrossRef
The first experience with the fully-covered self-expandable nitinol stents in the management of anastomotic biliary strictures after orthotopic liver transplantation
A. V. Shabunin, I. Yu. Korzheva, G. M. Chechenin, S. S. Lebedev, P. A. Drozdov, O. S. Zhuravel, S. A. Astapovich
Almanac of Clinical Medicine.2020; 48(3): 171. CrossRef
Endoscopic Management of Biliary Issues in the Liver Transplant Patient
James F. Crismale, Jawad Ahmad
Gastrointestinal Endoscopy Clinics of North America.2019; 29(2): 237. CrossRef
Endoscopic management of anastomotic stricture after living-donor liver transplantation
Dong Wook Lee, Jimin Han
The Korean Journal of Internal Medicine.2019; 34(2): 261. CrossRef
Efficacy of Nasobiliary Tubes and Biliary Stents in Management of Patients with Bile Leak after Liver Transplantation: A Systematic Review
Ali Raza, Anam Omer, Sara Iqbal, Vineet Gudsoorkar, Pramoda Koduru, Kumar Krishnan
Clinical Endoscopy.2019; 52(2): 159. CrossRef
Endoscopic management of biliary strictures post-liver transplantation
Ahmed Akhter, Patrick Pfau, Mark Benson, Anurag Soni, Deepak Gopal
World Journal of Meta-Analysis.2019; 7(4): 120. CrossRef
Liver transplant–related anastomotic biliary strictures: a novel, rapid, safe, radiation-sparing, and cost-effective management approach
Monique T. Barakat, Robert J. Huang, Nirav C. Thosani, Abhishek Choudhary, Mohit Girotra, Subhas Banerjee
Gastrointestinal Endoscopy.2018; 87(2): 501. CrossRef
Long‐term outcomes of early compared to late onset choledochocholedochal anastomotic strictures after orthotopic liver transplantation
Sanjaya K. Satapathy, Imran Sheikh, Bilal Ali, Fazal Yahya, Mehmet Kocak, Laxmi Babu Parsa, James D. Eason, Jason M. Vanatta, Satheesh P. Nair
Clinical Transplantation.2017;[Epub] CrossRef
Challenges of Endoscopic Management of Pancreaticobiliary Complications in Surgically Altered Gastrointestinal Anatomy
Tin Moe Wai, Eun Young Kim
Clinical Endoscopy.2016; 49(6): 502. CrossRef

9,923 View
192 Download
17 Web of Science
16 Crossref

Successful Removal of a Large Common Bile Duct Stone by Using Direct Peroral Cholangioscopy and Laser Lithotripsy in a Patient with Severe Kyphosis: Song I Lee, Byung Hun Lim, Won Gak Heo, Young Jun Kim, Tae Hyeon Kim; Clin Endosc 2016;49(4):395-398. Published online March 22, 2016; DOI: https://doi.org/10.5946/ce.2015.109

Abstract PDF PubReader ePub

A 75-year-old woman with hypertension presented with acute suppurative cholangitis. Chest radiography revealed severe kyphosis. Abdominal computed tomography revealed a large stone impacted in the common bile duct (CBD). The patient underwent emergent endoscopic retrograde cholangiopancreatography, and cholangiography revealed a large stone (7×3 cm) in the CBD that could not be captured using a large basket. We could not use the percutaneous approach for stone fragmentation by using a cholangioscope because of severe degenerative kyphosis. Finally, we performed holmium laser lithotripsy under peroral cholangioscopy by using an ultraslim endoscope, and the large stone in the CBD was successfully fragmented and removed without complications.

Citations

Citations to this article as recorded by

Innovation of endoscopic management in difficult common bile duct stone in the era of laparoscopic surgery
Cosmas Rinaldi Adithya Lesmana, Maria Satya Paramitha, Laurentius Adrianto Lesmana
World Journal of Gastrointestinal Endoscopy.2021; 13(7): 198. CrossRef
Endoscopic Management of Difficult Bile Duct Stones
Murad Aburajab, Kulwinder Dua
Current Gastroenterology Reports.2018;[Epub] CrossRef

10,853 View
115 Download
2 Web of Science
2 Crossref

The Usefulness of 64-Multidetector CT Cholangiography for Diagnosis of Distal Common Bile Duct Obstruction: Comparison with Endoscopic Retrograde Cholangiopancreatography: Jae-Hyun Choi, M.D., Mee Yeon Lee, M.D., Won Joong Jeon, M.D., Hee Bok Chae, M.D., Seon Mee Park, M.D., Sei Jin Youn, M.D., Jae-Woon Choi, M.D.* and Il Heon Bae, M.D.^†; Korean J Gastrointest Endosc 2009;39(1):14-21. Published online July 30, 2009

Abstract PDF: Background
/Aims: The aim of this study was to evaluate the diagnostic accuracy of 64-multidetector CT (MDCT) cholangiography for determining the causes of distal common bile duct (CBD) obstruction.
Methods
Two hundred fifty consecutive patients underwent 64-MDCT for diagnosing the clinical and biochemical signs of bile duct obstruction. The causes of bile duct obstruction were assessed by the pre- and post-enhanced axial and coronal multiplanar reformation images of 64-MDCT. The results were compared with ERCP, biopsy and surgery.
Results
The sensitivity and specificity of MDCT for CBD stones were 96.1% and 84.9%, respectively. In seven patients, The CBD stones in 7 patients could not be detected on MDCT. Eleven patients with stones in the distal CBD, as detected on MDCT, had no stones seen on ERCP. For malignant obstruction, the sensitivity and specificity of MDCT were 97.0% and 98.6%, respectively. Three patients who were diagnosed with periampullary cancers on MDCT were disclosed to have severe papillitis on ERCP. One patient who was diagnosed with CBD stone by MDCT was disclosed to have ampullary cancer. The overall accuracy of MDCT for determining the causes of biliary obstruction was 90.5%.
Conclusions
MDCT cholangiography is a non-invasive method with relatively high sensitivity and high specificity for diagnosing the causes of distal CBD obstruction. (Korean J Gastrointest Endosc 2009;39:14-21)

2,109 View
6 Download

Preoperatively Diagnosed Asymptomatic Early Extrahepatic Bile Duct Cancer: Kyung Ran Cho, M.D., Ho Soon Choi, M.D., Sun Young Yang, M.D., Jai Hoon Yoon, M.D., Hang Lak Lee, M.D., Oh Young Lee, M.D., Byung Chul Yoon, M.D., Jun Soo Hahm, M.D., Min Ho Lee, M.D., Dong Hoo Lee, M.D. and Chun Suk Kee, M.D.; Korean J Gastrointest Endosc 2005;30(6):340-344. Published online June 30, 2005

Abstract PDF: Cholangiocarcinoma is usually diagnosed at the advanced stage because early symptoms and signs are relatively infrequent. The preoperative diagnosis of early extrahepatic bile duct cancer in common bile duct is uncommon. Also, an extrahepatic bile duct cancer arising from the lower portion of the common bile duct is usually papillary and rarely nodular or sclerosing. We decribe a case, preoperatively diagnosed as early extrahepatic bile duct cancer in lower portion of common bile duct, nodular type on endoscopic retrograde cholangiography. It was incidentally detected by the slight elevation ofγ-glutamyl transpeptidase without any symptoms. An endoscopic retrograde cholangiography showed abrupt narrowing of the intrapancreatic portion of the common bile duct with irregular and nodular filling defect. The lesion was confined to mucosa on the endoscopic ultrasonography. This patient was diagnosed as early extrahepatic bile duct cancer and underwent Whipple's operation. A histopathologic examination of resected specimen revealed to be moderately differentiated adenocarcinoma at stage 1 (T1N0Mo) in the extrahepatic bile duct. (Korean J Gastrointest Endosc 2005;30:340⁣344)

1,870 View
5 Download

Common Bile Duct Varices: MR Cholangiography and MR Angiography Demonstration: Jin Tae Park, M.D., Myung-Hwan Kim, M.D., Moon Hee Song, M.D., Jung Joon Choi, M.D., Tae Hoon Lee, M.D., Eun Hee Ko, M.D., Won Jang Kim, M.D., Dong Ryoul Oh, M.D., Sang Soo Lee, M.D., Dong Wan Seo, M.D., Sung Koo Lee, M.D. and Young Il Min, M.D.; Korean J Gastrointest Endosc 2003;27(2):96-99. Published online August 30, 2003

Abstract PDF: Extrahepatic obstruction of the portal vein, resulting in portal hypertension, may cause extensive collateral circulation at the porta hepatis. These collateral veins may compress and narrow the common bile duct, sometimes causing obstructive jaundice. Until recently, ERCP and percutaneous angiography have been used to diagnose choledochal varix. Now, MR cholangiography is replacing the diagnostic role of ERCP. This imaging has the advantage of obtaining angiography at the same time. We present a 62-year-old male patient, in whom choledochal varix accompanying choledocholithiasis, was diagnosed by MR cholangiography and contrast-enhanced MR angiography. (Korean J Gastrointest Endosc 2003;27:96⁣99)

1,720 View
3 Download

간문부 담관암의 담도내 종적 침윤 평가에 있어 자기공명 담관조영술과 경피경간 담도경 성적의 비교: Korean J Gastrointest Endosc 2001;23(5):318-318. Published online November 30, 2000

PDF

1,562 View
5 Download

원저 : 담도 췌장 : 담도의 다발성 유두종 9예 ( Original Articles : Biliary Tract & Pancreas ; An Analysis of Nine Cases of Multiple Biliary Papillomatosis ): Korean J Gastrointest Endosc 1998;18(5):681-689. Published online November 30, 1997

Abstract PDF: Background
and Study Aims: Multiple biliary papillomatosis (MBP) is an uncommon disease. This study was undertaken to review cases with respect to describing clinical features and characteristical cholangiographic findings, and to define the role of cholangioscopy in the diagnosis and treatment of this disorder. Patients and Methods: from 1990 to 1997, nine patients (mean age; 57.3 years, 6 men and 3 women) were diagnosed as having MBP arnong 5,361 cases of endoscopic retrograde cholangiography (ERC) conducted at our center. A retrospective analyses of the cholangiographic and cholangioscopic findings as well as clinieal features were performed.(Korean J Gastrointest Endosc 18: 681-687, 1998)

1,561 View
2 Download

증례 : 담도 췌장 ; 원발성 경화성 담관염 환자에서 MR Cholangiography 와 CT Cholangiography 의 임상적 유용성 ( Case Reports : Biliary Tract & Pancreas ; Clinical Usefulness of Magnetic Resonance Cholangiagraphy and Computed Tomography Cholangiography in Primary Sclerosing Cholangitis ): Korean J Gastrointest Endosc 1997;17(5):716-722. Published online November 30, 1996

Abstract PDF: Primary sclerosing cholangitis(PSC) is rare disease which is characterized by inflammation and obliteration of bile duct leading to biliary cirrhosis and liver failure. The cause of PSC is unknown although a number of potential etiologic factor have been investigated. The diagonsis is confirmed by typical cholangiographic demonstration with clinical features. On endoscopic retrograde cholangiopancreatography(ERCP), multifocal strictures involving both intra and extrahepatic bile ducts are most common; they were diffusely distributed, short, and annular, alternating with normal or slightly dilated segments to produce a "beaded" appearance, the "pruned-tree" appearance due to diminished arborization of the intrahepatic duct, band-like stricture, and diverticular-like outpouching(s) are seen occasionally on cholangiography, and the report of primary sclerosing cholangitis in Korea is being increased due to increased use of ERCP. Recently, magnetic resonance cholangiography(MR cholangiography) and computed tomography cholangiography(CT cholangiography) are newly developed adjunctives for evaluation of patients with biliary disease(s). We performed MR cholangiography and CT cholangiography through the nasobiliary tube in two patients with PSC, in which typical intrahepatic bile duct changes of PSC were seen as in ERCP. Now, we report MR cholangiographic and CT cholangiographic findings in patients with PSC and suggest that these radiologic studies, especially MR cholangiography, can be used as an alternative methods for serial follow-up after definite diagnosis by ERCP. (Korean J Gastrointest Endosc 17: 716-722, 1997)

1,645 View
4 Download

원저 : 담도 췌장 ; 담낭 담석으로 인한 복강경 담낭절제술시 총담관결석 동반 유무의 예측과 치료 ( Original Articles : Biliary Tract & Pancreas ; Prediction and Management of Choledocholithiasis in Patients Undergoing Laparoscopic Cholecystectomy due to Cholelithiasis ): Korean J Gastrointest Endosc 1997;17(5):632-639. Published online November 30, 1996

Abstract PDF: Background
/Aims: Endoscopic retrograde cholangiopancreatography(ERCP) or operative cholangiography is the procedure to demonstrate and remove stones of the biliary tree in patients undergoing laparoscopic cholecystectomy(LC) due to cholelithiasis. However, ERCP or operative cholangiography is an invasive procedure. The next question then is when and for what indication should ERCP or operative cholangiography be performed. The aims of this study were to assess whether prediction of common bile duct(CBD) stones by the noninvasive method such as liver function test and/or clinical findings is possible, and to investigate which method is more adequate for removal of CBD stones found on ERCP or operative cholangiography. Methods: A total 207 patients with symptomatic cholelithiasis scheduled for LC were enrolled from September 1993 to August 1996. Patients who were already found to have either extrahepatic or intrahepatic biliary stones on sonogram were excluded. Patients were classified into risk group and non-risk group. Patients who belong to the risk group were those having CBD dilatation by ultrasonography, history of jaundice or cholangitis, gallstone pancreatitis, or elevated transaminases. (Korean J Gastrointest Endosc 17: 632-639, 1997) (continue)

1,579 View
2 Download

원저 : 담도 췌장 ; 내시경적 유두괄약근절개술과 담췌관조영술시 침형절개도의 효율성과 안전성 ( Original Articles : Biliary Tract & Pancreas ; The Efficacy and Safety of Needle-Knife Papillotomy for Endoscopic Sphincterotomy and Cholangiography ): Korean J Gastrointest Endosc 1997;17(3):380-389. Published online November 30, 1996

Abstract PDF: Background
Conventional endoscopic sphincterotomy with papillotome(CES) is an established method of management for patients with biliary obstruction from various causes. However, an alternative treatment to CES must be considered when antecedent cholangiagraphy is unsuccessful or when cannulatian with the conventional papillotome fails. The needle-knife papillotomy(NKP) is one of the alternative methods to CES. Recently, it has been suggested that NKP can be used to achieve diagnostic cholangiography. But NKP is controversial because results from studies assessing its efficacy and safety are conflicting. The current study was undertaken to assess retrospectively the efficacy and safety of NKP and CES. Methods: All enrolled patients(CES group 113, NKP group 105) underwent ERCP between September 1993 and August 1996 at Korea Univeisity Guro Hospital. NKP for cannulation was used only when biliary tract disease was suspected but deep canulation failed inspite of several attempts. The efficacy and safety of NKP and CES were evaluated according to the rate of success of performing purposes(removal of common bile duct stones, inser tion of endoscopic nasobiliary drainage or endoprosthesis, treatment of sphincter of Oddi dysfunction, and cannulation) and complications(bleeding, perforation, pancreatitis). (Korean J Gastrointest Endosc 17: 380-389, 1997) (continue)

1,601 View
7 Download

원저 : 담도 췌장 ; 간외담관 담석증에서의 초음파내시경의 진단적 유용성 ( Original Articles : Biliary Tract & Pancreas ; Effectiveness of Endoscopic Ultrasonography in Detecting the Extrahepatic Choledocholithiasis ): Korean J Gastrointest Endosc 1997;17(1):23-31. Published online November 30, 1996

Abstract PDF: Backgroud/Aims: Ultrasonography is the easiest, fastest procedure for the diagnosis of choledocholithiasis, but the diagnostic failure are mostly because of the intrapancreatic level of this condition and the absence of bile duct dillatation. Endoscopic ultrasonography is a promising procedure for the diagnosis of extrahepatic cholestasis due to noninvasiveness and accuracy in the digestive gas interposition. The aim of this study was to prospectively compare the diagnostic accuracy of endoscopie ultrasonography with abdominal ultrasonography and endoscopic retrograde cholangiography in 66 patients with suspected choledocholithiasis. Methods: All of the patients had abdominal ultrasonography, endoscopic ultrasonography ~and endoscopie retrograde cholangiography within 72 hours and final diagnosis was determined by endoseopic retrograde cholangiography with sphincterotomy. Results: (l) Choledocholithiasis was confirmed in 45 patients: Thirteen patients had nondilated common bile ducts and 20 patients had stones with diamerer < 1 cm. (2) Endoscopic ultrasonography was more sensitive(95.5%) than abdominal ultrasonography (44.4%: P<0.0001) and similar to endoscopic retrograde cholangiography (97.8%). Specificity was same as 100% in 3 diagnostic tools. (3) Endoscopic ultrasonography was superior to abdommal ultrasonography for the diagnosis of choledocholithiasis with nondilated common bile duct(100% vs 15.3%, P<0.0001) and with less than 1cm sized small stone(100% vs 10.0%, P<0.0001). Endoscopic ultrasonography results did not depend on stone diameter or common bile duct dilatation. Conclusions: Endoscopic ultrasonography could be an accurate and safe diagnostic tool for the diagnosis of choledocholithiasis and could be promising especially in the cases with difficult cannulation of bile duct and gal1 stone pancreatitis. (Korean J Gastrointest Endosc 17: 23-31, 1997)

1,779 View
10 Download

증례 : 담도 췌장 ; 외상후에 발생한 Biloma 1예 ( Case Reports : Biliary Tract & Pancreas ; A Case of Posttraumatic Biloma ): Korean J Gastrointest Endosc 1995;15(4):783-787. Published online November 30, 1994

Abstract PDF: Biloma is defined as an extraductular collection of bile within a defined capsular space. Biloma usually occurs secondary to traumatic or iatrogenic injury including abdominal surgery, percutaneous catheter drainage, and transhepatic cholangiography. The diagnostic methods include clinical history and physical examination, abdominal ultrasound, abdominal CT scan, hepatobiliary scintigraphy, endoscopic cholangiography and percutaneous aspiration, Though definite treatment by percutaneous radiographic catheter drainage and endoscopic drainage with sphincterotomy are now feasible in many instances, surgical drainage is often needed. We report a case of posttraurnatic biloma which was developed after car accident. Liver scan and endoscopic cholangiography showed typical features of biloma in this patient. (Kor J Gastrointest Endonc l5: 783-787, 1995)

1,391 View
4 Download

증례 : 바륨을 이용한 내시경적 역행성 담췌관 조영술 ( Case Reports : Endoscopic Retrograde Cholangiopancreatography Using Barium Sulfate As a Contrast Material ): Korean J Gastrointest Endosc 1994;14(1):111-114. Published online November 30, 1993

Abstract PDF: An occasional patient has both a pressing need for visualization of the biliary system in spite of a past history of reaction to iodinated contrast media. We report a patient, who had reacted adversely to contrast media, underwent ERCP using barium sulfate in order to opacify the biliary and pancreatic duct without side effect successfully. In conclusion, ERCP using barium sulfate as a contrast material is of value in patients who are intolerant of the iodinated contrast media.

1,582 View
6 Download

Search