Cholangiography ; Humans

The antegrade puncture technique represents a new approach to percutaneous transhepatic cholangiography andbiliary drainage. With this technique, ductal puncture begins with the liver capsule toward the hepaticparenchyma. This report briefly describes this new technique, and its safety and feasibility.
Cholangiography* ; Drainage* ; Liver ; Punctures*

Places ; Percutaneous transhepatic cholangiography ; Icterus

A bronchobiliary fistula is rare disorder, consisting of the abnormal communication between the bronchial tree and the biliary duct. We describe a 78-year-old man who had a bronchobiliary fistula caused by choledocholithiasis. The diagnosis was confirmed by the presence of bilioptysis (bile-stained sputum) and the percutaneous transhepatic cholangiography (PTC). The patient was treated successfully by percutaneous transhepatic biliary drainage (PTBD) with stone extraction and was followed by healing of the bronchobiliary fistula without surgical intervention.
Aged ; Cholangiography ; Choledocholithiasis* ; Diagnosis ; Drainage ; Fistula* ; Humans

BACKGROUNDS 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. PATIENATS 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.
Cholangiography ; Diagnosis ; Humans ; Male ; Papilloma* ; Retrospective Studies

In cholangiographic techniques, the close relationship between choledochal cyst and anomalous union of pancreaticobiliary duct has attracted medical attention. There have been rare cases in which the papilla of Vater was found in a position other than its normal position, and such cases have been reported sporadically. However, such cases are interesting in the anatomical context. In this review, we present our experience of choledochal cyst in a 30-month-old boy in whom the papilla of Vater was positioned in the third portion of the duodenum.
Cholangiography ; Choledochal Cyst ; Duodenum ; Preschool Child

PURPOSE: To compare T2-weighted MR cholangiography (T2-MRC) and contrast-enhanced T1-weighted MRC (enhanced T1-MRC) in the assessment of biliary anatomy in donor candidates for living related liver transplantation (LRLT). MATERIALS AND METHODS: Thirty-three potential donors underwent MR examination for preoperative evaluation. Using the single-shot half-Fourier RARE sequence, T2-weighted single-section and coronal images were obtained, and enhanced T1-MRC was performed, using 3D GRE sequences after the administration of mangafodifir trisodium. To assess the hilar ductal branching pattern and determine diagnostic confidence, two reviewers first evaluated the unpaired T2-MRC and enhanced T1-MRC images, and then paired T2-MRC and enhanced T1-MRC images together. In particular, in 12 cases in which direct cholangiographys were performed, the feasibility of single duct-to-duct anastomosis was assessed using the unpaired and the paired sets sequentially. RESULTS: The reviewers' confidence tended to be higher for enhanced T1-MRC than T2-MRC, but the difference was not statistically significant. For both reviewers, confidence was significantly higher for the paired set than for T2- or enhanced T1-MRC alone (p < .001). The types of biliary anatomy determined in the paired set matched the consensus reading in 33 (100%) and 30 cases(91%) assessed by reviewer 1 and 2, respectively. The separate interpretation of T2- and enhanced T1-MRC findings matched the consensus interpretation in 30 (91%) and 28 cases (85%), respectively, assessed by reviewer 1, and 26 (79%) and 28 cases (85%), respectively, assessed by reviewer 2. The possibility of single anastomosis was accurately predicted in 91.6% of cases in T2-MRC, and 100% at enhanced T1-MRC and the combined set. CONCLUSION: In the evaluation of the biliary anatomy of potential donors for LRLT, the combined use of T2-MRC and enhanced T1-MRC may improve diagnostic confidence and decrease the occurrence of a non diagnostic or equivocal interpretation at T2-MRC alone.
Adult* ; Cholangiography* ; Consensus ; Humans ; Liver Transplantation ; Liver* ; Tissue Donors*

Biliary atresia (BA) with extrahepatic biliary cysts (EHBC) is a rare disease. It has been generally recognized as type I (correctable with cystic dilatation), which means a good prognosis. From a total of 73 patients with BA who underwent operation from September 1988 to September 2003 at our institute, 7 (9.6 %) cases of type III BA with EHBC (uncorrectable with cystic dilatation) are reviewed. Clinical findings, laboratory data, radiologic findings, treatment methods and outcomes were reviewed. Female was more prevalent (male to female ratio; 2:5). All cases were type III with EHBC according to the intraoperative cholangiography, and underwent Kasai's portoenterostomy. The mean age was 57 days at operation. Three patients(42.9 %) are long term survivors. Further evaluation is needed to determine the correlation between prognostic factors and outcome for.
Biliary Atresia* ; Cholangiography ; Female ; Humans ; Prognosis ; Rare Diseases ; Survivors

PURPOSE: To evaluate the usefulness of multi-detector row helical CT (MDCT), multiplanar reformatted images for the noninvasive assessment of biliary stent patency, and for the planning for management in patients with a self-expandable metallic stent due to malignant biliary obstruction. MATERIALS AND METHODS: Among 90 consecutive patients, from August 1999 to July 2003, 26 cases in 23 patients with malignant biliary obstruction who underwent self-expandable metallic stent insertion in the biliary system and percutaneous transhepatic biliary drainage within 7 days after CT were enrolled in this study. On CT images, the complete and functional obstruction of the stent and the precise level of obstruction were evaluated. The presence of an enhancing intraluminal mass or wall thickening around stent was determined, and the causes of obstruction were evaluated. These findings were then compared with percutaneous transhepatic cholangiography. RESULTS: Multi-detector row helical CT correctly demonstrated the patency of a stent in 24 cases (92.3%). It was adequate in helping to depict the precise level of stent occlusion in 23 cases (88.5%). Multi-detector row helical CT also revealed the extent of tumor that represented as an enhancing intraluminal mass or wall thickening around the stent in 23 cases, and this was represented as complete obstruction on percutaneous transhepatic cholangiography. In the case of functional obstruction, MDCT predicted the possible cause of the obstruction. CONCLUSION: Multiplanar reformatted images of multi-detector row helical CT is a useful imaging modality for the noninvasive assessement of stent patency and the precise level of obstruction when stent obstrution is suspected in the patients with self-expandable metallic stent due to malignant biliary obstruction. It can also predict the possible cause of the obstruction and allows adequate planning for the medical management of such cases.
Biliary Tract ; Cholangiography ; Drainage ; Humans ; Stents* ; Tomography, Spiral Computed*

PURPOSE: To evaluate the diagnostic accuracy of T-tube cholangiography(TTC), selective cholangiography (SC) and noncontrast CT(NCT) in the evaluation of intrahepatic stone disease. MATERIALS AND METHODS: We retrospectively analyzed the radiological findings of these methods in thirty patients with intrahepatic stones proved by percutaneous removal. Findings of each procedure were reviewed and correlated with findings of stone removal procedure. RESULTS: Detection of stones was possible in 87. 0% for TTC, 90. 0% for SC, 96. 7% for NCT(p > 0.05). Selective cholangiography was as good as or superior to 1-I'C in determining the presence and extent of the stones in all patients(p < 0. 01). NCT was better than SC in 9;as good as SC in 18;inferior to SC in 3 patients in determining the extent and location of the stones(p > 0.05). Of 12 patients who had additional findings such as biliary cirrhosis or accompanied cholangiocarcinomas, only NCT could detect the lesions in 11 patients. CONCLUSION: Although there was no statistically significant difference between NCT and SC, one procedure sometimes gave valuable informations for interventional procedure which the other could not. Thus we conclude that both procedures are complementary studies and should be done in all patients who are subjected to biliary intervention.
Cholangiocarcinoma ; Cholangiography* ; Humans ; Liver Cirrhosis, Biliary ; Retrospective Studies