scholarly journals Percutaneous transhepatic cholangiography versus endoscopic retrograde cholangiography for the pathological diagnosis of suspected malignant bile duct strictures

Medicine ◽  
2020 ◽  
Vol 99 (11) ◽  
pp. e19545
Author(s):  
Hai-Yang Chang ◽  
Bin Liu ◽  
Yong-Zheng Wang ◽  
Wu-Jie Wang ◽  
Wei Wang ◽  
...  
Keyword(s):  
Bile Duct ◽  
Percutaneous Transhepatic Cholangiography ◽  
Endoscopic Retrograde Cholangiography ◽  
Pathological Diagnosis ◽  
Endoscopic Retrograde

scholarly journals Double-balloon endoscopic retrograde cholangiography can make a reliable diagnosis and good prognosis for postoperative complications of congenital biliary dilatation

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chiyoe Shirota ◽  
Hiroki Kawashima ◽  
Takahisa Tainaka ◽  
Wataru Sumida ◽  
Kazuki Yokota ◽  
...  
Keyword(s):  
Bile Duct ◽  
Postoperative Complications ◽  
Radical Surgery ◽  
Endoscopic Retrograde Cholangiography ◽  
Endoscopic Retrograde ◽  
Congenital Biliary Dilatation ◽  
Intrahepatic Stones ◽  
Biliary Dilatation ◽  
Double Balloon ◽  
Anastomotic Strictures

AbstractBile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. Bile duct and anastomotic strictures and intrahepatic stones are common postoperative complications of congenital biliary dilatation (CBD). We performed double-balloon endoscopic retrograde cholangiography (DBERC) for diagnostic and therapeutic purposes after radical surgery. We focused on the effectiveness of DBERC for the treatment of postoperative complications of CBD patients. This retrospective study included 28 patients who underwent DBERC (44 procedures) after radical surgery for CBD between January 2011 and December 2019. Strictures were diagnosed as “bile duct strictures” if endoscopy confirmed the presence of bile duct mucosa between the stenotic and anastomotic regions, and as “anastomotic strictures” if the mucosa was absent. The median patient age was 4 (range 0–67) years at the time of primary surgery for CBD and 27.5 (range 8–76) years at the time of DBERC. All anastomotic strictures could be treated with only by 1–2 courses of balloon dilatation of DBERC, while many bile duct strictures (41.2%) needed ≥ 3 treatments, especially those who underwent operative bile duct plasty as the first treatment (83.3%). Although the study was limited by the short follow-up period after DBERC treatment, DBERC is recommended as the first-line treatment for hepatolithiasis associated with biliary and anastomotic strictures in CBD patients, and it can be safely performed multiple times.

scholarly journals Role of Endoscopic Retrograde Cholangiography and Nasobiliary Drainage in the Management of Postoperative Biliary Leak

1997 ◽  
Vol 3 (4) ◽  
pp. 221-229 ◽  
Author(s):  
M. K. Goenka ◽  
R. Kochhar ◽  
D. Bhasin ◽  
B. Nagi ◽  
J. D. Wig ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiography ◽  
Biliary Leak ◽  
Endoscopic Retrograde ◽  
Large Defect ◽  
Endoscopic Nasobiliary Drainage ◽  
Associated Lesions ◽  
Nasobiliary Drainage

In order to assess the role of endoscopic retrograde cholangiography in evaluating the patients with post-operative biliary leak and of endoscopic nasobiliary drainage in its management, 36 patients with biliary leak seen over a period of 9 years were studied. Thirty-two had biliary leak following cholecystectomy, 3 following repair of liver trauma and 1 following choledochoduodenostomy. Patients presented at an interval of 4 days to 210 days (mean ± SEM, 32.4 ± 6.7 days) following laparotomy. Hyperbilirubinemia was noticed in only 13 patients (36.1%), while abdominal ultrasonogram showed ascites or biloma in 24 (66.7%). Endoscopic retrograde cholangiography showed the leak to involve the common bile duct in 55.6%, cystic duct in 33.3% and intrahepatic biliary radicles in 8.3%. Associated lesions included bile duct obstruction due to stricture or accidental ligature in 20%, bile duct stone in 20% and liver abscess in 2.8%.Endoscopic nasobiliary drainage using a 7 Fr pig-tail catheter was attempted in 14 patients and could be established in 12 of them. Bile duct leak sealed in all but one of these 12 patients after an interval of 3 days to 40 days (mean ± SEM, 12.2 ± 3.2 days). A single patient with large defect and a proximal bile duct stricture did not respond and required surgery. Common bile duct stones were removed by endoscopic sphincterotomy in 3 out of 4 patients. One patient with large stone required surgical choledocholithotomy. In conclusion, endoscopic retrograde cholangiography was safe and useful in confirming the presence of leak as well as its site, size and associated abnormalities. Endoscopic nasobiliary drainage proved an effective therapy in post-operative biliary leak and could avoid re-exploration in 71.4% patients.

scholarly journals Endoscopic ultrasound versus endoscopic retrograde cholangiography for the diagnosis of choledocholithiasis: the influence of the size of the stone and diameter of the common bile duct

2005 ◽  
Vol 42 (4) ◽  
pp. 239-243 ◽  
Author(s):  
Marcus Vinicius Silva Ney ◽  
Fauze Maluf-Filho ◽  
Paulo Sakai ◽  
Bruno Zilberstein ◽  
Joaquim Gama-Rodrigues ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Ultrasound ◽  
Common Bile Duct Stones ◽  
Endoscopic Retrograde Cholangiography ◽  
Bile Duct Stones ◽  
Endoscopic Retrograde ◽  
The Common ◽  
Common Bile Duct Diameter

BACKGROUND: Endoscopic retrograde cholangiography is highly accurate in diagnosing choledocholithiasis, but it is the most invasive of the available methods. Endoscopic ultrasonography is a very accurate test for the diagnosis of choledocholithiasis with a risk of complications similar to that of upper gastrointestinal endoscopy. AIM: To compare the accuracy of endoscopic ultrassonography and endoscopic retrograde cholangiography in the diagnosis of common bile duct stones before laparoscopic cholecystectomy and to analyze endoscopic ultrasound results according to stone size and common bile duct diameter. PATIENTS AND METHODS: Two hundred and fifteen patients with symptomatic gallstones were admitted for laparoscopic cholecystectomy. Sixty-eight of them (31.7%) had a dilated common bile duct and/or hepatic biochemical parameter abnormalities. They were submitted to endoscopic ultrassonography and endoscopic retrograde cholangiography. Sphincterotomy and sweeping of the common bile duct were performed if endoscopic ultrassonography or endoscopic retrograde cholangiography were considered positive for choledocholithiasis. After sphincterotomy and common bile duct clearance the largest stone was retrieved for measurement. Endoscopic or surgical explorations of the common bile duct were considered the gold-standard methods for the diagnosis of choledocholithiasis. RESULTS: All 68 patients were submitted to laparoscopic cholecystectomy with intraoperative cholangiography with confirmation of the presence of gallstones. Endoscopic ultrassonography was a more sensitivity test than endoscopic retrograde cholangiography (97% vs. 67%) for the detection of choledocholithiasis. When stones >4.0 mm were analyzed, endoscopic ultrassonography and endoscopic retrograde cholangiography presented similar results (96% vs. 90%). Neither the size of the stone nor the common bile duct diameter had influence on endoscopic ultrasonographic performance. CONCLUSIONS: For a group of patients with an intermediate or moderate risk with respect to the likelihood of having common bile duct stones, endoscopic ultrassonography is a better test for the diagnosis of choledocholithiasis when compared to endoscopic retrograde cholangiography mainly for small-sized calculi.

scholarly journals Selective preoperative endoscopic retrograde cholangiography with sphincterotomy avoids bile duct exploration during laparoscopic cholecystectomy.

Gut ◽  
1995 ◽  
Vol 37 (4) ◽  
pp. 576-579 ◽  
Author(s):  
C R Welbourn ◽  
D Mehta ◽  
C P Armstrong ◽  
M W Gear ◽  
I A Eyre-Brook
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Bile Duct ◽  
Endoscopic Retrograde Cholangiography ◽  
Endoscopic Retrograde

scholarly journals Use of magnetic resonance cholangiography in the diagnosis of choledocholithiasis: prospective comparison with a reference imaging method

Gut ◽  
1999 ◽  
Vol 44 (1) ◽  
pp. 118-122 ◽  
Author(s):  
S H Zidi ◽  
F Prat ◽  
O Le Guen ◽  
Y Rondeau ◽  
L Rocher ◽  
...  
Keyword(s):  
Bile Duct ◽  
Magnetic Resonance ◽  
Predictive Value ◽  
Endoscopic Retrograde Cholangiography ◽  
Magnetic Resonance Cholangiography ◽  
Imaging Method ◽  
Bile Duct Stones ◽  
Endoscopic Retrograde ◽  
Standard Equipment ◽  
Prospective Comparison

BackgroundMagnetic resonance cholangiography (MRC) is a new technique for non-invasive imaging of the biliary tract.AimTo assess the results of MRC in patients with suspected bile duct stones as compared with those obtained with reference imaging methods.Patients/Methods70 patients (34 men and 36 women, mean (SD) age 71 (15.5) years; median 75) with suspected bile duct stones were included (cholangitis, 33; pancreatitis, three; suspected post-cholecystectomy choledocholithiasis, nine; cholestasis, six; stones suspected on ultrasound or computed tomography scan, 19). MR cholangiograms with two dimensional turbo spin echo sequences were acquired. Endoscopic retrograde cholangiography with or without sphincterotomy (n = 63), endosonography (n = 5), or intraoperative cho- langiography (n = 2) were the reference imaging techniques used for the study and were performed within 12 hours of MRC. Radiologists were blinded to the results of endoscopic retrograde cholangiography and previous investigations.Results49 patients (70%) had bile duct stones on reference imaging (common bile duct, 44, six of which impacted in the papilla; intrahepatic, four; cystic duct stump, one). Stone size ranged from 1 to 20 mm (mean 6.1, median 5.5). Twenty seven patients (55%) had bile duct stones smaller than 6 mm. MRC diagnostic accuracy for bile duct lithiasis was: sensitivity, 57.1%; specificity, 100%; positive predictive value, 100%; negative predictive value, 50%.ConclusionsStones smaller than 6 mm are still often missed by MRC when standard equipment is used. The general introduction of new technical improvements is needed before this method can be considered reliable for the diagnosis of bile duct stones.

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