Clinical Application of Peroral Cholangioscopy in Biliary Diseases.
- Author:
Chun Kyon LEE
1
;
Jae Bock CHUNG
;
Si Young SONG
;
Se Joon LEE
;
Young Myoung MOON
;
Jin Kyung KANG
;
In Suh PARK
Author Information
1. Department of Internal Medicine, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Peroral cholangioscopy;
Biliary disease;
Stone
- MeSH:
Bile;
Bile Duct Neoplasms;
Bile Ducts;
Cholangitis;
Common Bile Duct;
Constriction, Pathologic;
Cystadenocarcinoma;
Diagnosis, Differential;
Humans;
Hyperamylasemia;
Lithotripsy;
Pancreatitis;
Retrospective Studies
- From:Korean Journal of Gastrointestinal Endoscopy
1998;18(2):176-182
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Peroral cholangioscopy (PCS) was usually conducted for a differential diagnosis in cases which were difficult to diagnose on a routine endoscopic retrograde cholangiogram (ERC) or during fragmentation of a large bile duct stone with electrohydraulic lithotripsy. This study was conducted to evaluate the clinical utility of a PCS in biliary diseases. METHOD: We retrospectively reviewed the clinical records of 31 patients in whom a PCS was performed to evaluate various biliary diseases from July 1991 to Aug. 1996. RESULT: A peroral cholangioscope was successfully inserted into the bile duct in 90.3% (28/31) of the patients. The underlying diseases included bile duct stones (11 cases), bile duct cancer (9 cases), benign bile duct strictures (2 cases), benign bile duct turnors (2 cases), biliary cystadenocarcinoma (2 cases), emboli of the HCC in the bile duct(1 case), and common bile duct polyposis (1 case). Most PCSs were performed for the differential diagnosis between benign and malignant bile duct strictures or obstructions (14 cases) and fragmentation of large bile duct stone with electrohydraulic lithotripsy (10 cases). Overall, the success rate was 78.6% (22/28) in achieving the purpose 88.9% (16/18) in diagnostic aim and 60.0% (6/10) in therapeutic aim. Complications from the PCS occurred in 4 cases (14.3%). Cholangitis and acute pancreatitis was found in 1 case and asymptomatic hyperamylasemia were discovered in 2 cases. CONCLUSION: PCS plays a major role in confirming difficult cases to diagnose using on ERC and fragment to remove large cornmon bile duct stones.
