The Role of Percutaneous Transhepatic Cholangioscopy in Patients with Hilar Strictures.
- Author:
Ju Young JUNG
1
;
Sung Koo LEE
;
Hyoung Chul OH
;
Tae Yoon LEE
;
Seung Hyun KWON
;
Sang Soo LEE
;
Dong Wan SEO
;
Myung Hwan KIM
Author Information
1. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. sklee@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Cholangiocarcinoma;
Cholangiography;
Cholangiopancreatography;
Magnetic resonance;
Neoplasms;
Vascular tissue
- MeSH:
Bile Ducts;
Biopsy;
Cholangiocarcinoma;
Cholangiography;
Chungcheongnam-do;
Constriction, Pathologic*;
Diagnosis, Differential;
Humans;
Medical Records;
Papilloma;
Retrospective Studies;
Seoul
- From:Gut and Liver
2007;1(1):56-62
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: Various diagnostic advantages of percutaneous transhepatic cholangioscopy (PTCS) for the determination of the range of tumor and for the characterization of cholangioscopic findings have been reported. The aim of our study is to evaluate the diagnostic and therapeutic role of PTCS in patients with hilar strictures and to investigate its causes. METHODS: We retrospectively studied the medical records and cholangioscopic reports of 177 patients who received PTCS for hilar strictures between January 2000 and December 2005 at Asan Medical Center, Seoul. For each patient, cholagnioscopy, biopsy result, computed tomography (CT) and magnetic resonance cholangiopancreaticography (MRCP), operation, and pathologic reports were collected. RESULTS: Most patients had malignant hilar strictures or biliary papillomatosis while a few had benign hilar strictures. Presence of tumor vessel on PTCS was a useful diagnostic tool since direct observation of the tumor vessel strongly suggested a malignant tumor in the bile duct. The sensitivity of tumor vessel alone was 56.1%, and sensitivity of PTCS biopsy alone was 76.9%. However, sensitivity of biopsy combined with cholangioscopy of the tumor vessel was 88.4%, which was statistically significant compared with biopsy or tumor vessel alone. CONCLUSIONS: PTCS biopsy combined with cholangioscopic observation was useful in differential diagnosis of hilar strictures. PTCS also had a therapeutic role in some patients with incurable malignant hilar lesion.
