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

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

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

PURPOSE: Choledochal cysts are cystic or diffuse dilatation of any portion of the biliary tree. An anomalous pancreaticobiliary ductal union (APBDU) is one of the commonly accepted causes of a cholodochal cyst. The ability of MRCP to demonstrate an APBDU has not been established in children and appears to have limited value in demonstrating an associated APBDU. We investigate the usefulness, and application, of MRCP in delineating the cyst type and an APBDU in patients with choledochal cysts, and compared it with operative cholangiography. METHODS: Ten children with choledochal cyst, who had both MRCP and cholangiography, as preoperative diagnostic modalities, at the Division of Pediatric Surgery, Keimyung University, Dongsan Medical Center, between March 1999 and August 2002, were selected for this study. We analyzed and compared their MRCP images with those of the intraoperative cholangiographies, with regard to the type of cyst, size and association of an APBDU. RESULTS: The types of the choledochal cyst, based on the MRCP, were two Ia, three Ic, and five IVa, whereas those based on the operative cholangiographies were one Ic and nine IVa. A common channel was demonstrated by MRCP and operative cholangiography in four (40%) and six (60%) of the ten patients, respectively. Each diagnostic modality correlated with the size (Pearson correlation, P<0.01) and the length of the cyst, but an APBDU on both modalities did not reach statistical significance, even though the common channel was not identified in a large cyst on MRCP. CONCLUSION: MRCP is a noninvasive and safe diagnostic modality for the delineation an APBDU in children with choledochal cysts. However, it has limited value for demonstrating an APBDU in children with a large cyst due to overlapping with the pancreaticobiliary ductal system. Operative cholangiography seems to be more valuable than MRCP in patients with large choledochal cysts.
Biliary Tract ; Child ; Cholangiography ; Choledochal Cyst* ; Diagnosis* ; Dilatation ; Humans

Gallbladder diverticula have the appearance of hernia-like protrusions of the gallbladder wall. This disorder may not be diagnosed until surgically resected because it has no clinical significance unless there are associated diseases. Gallbladder pseudodiverticula have an acquired cause, multiple fundal lesions, an association with gallstones, internal saccular lesions without external hernia-like protrusions, and little to no smooth muscle in the gallbladder wall. We report a unique anomaly of multiple pseudodiverticula presenting with calculous cholecystitis, which was pathologically different from true diverticula and had a unique shape similar to a bunch of grapes and a septation infilling pattern on endoscopic retrograde cholangiography.
Cholangiography ; Cholecystitis ; Diverticulum ; Gallbladder ; Gallstones ; Muscle, Smooth ; Vitis

Endoscopic retrograde cholangiography has now evolved into a highly sophisticated diagnostic and therapeutic tool in patients with hepatobiliary-pancreatic disorders. However, this procedure is associated with risks of significant complications such as cholangitis, pancreatitis, hemorrhage, and perforation which have been widely recognized. Hepatic subcapsular biloma is a very rare and less recognized complication of this procedure. Recently, we experienced a case of hepatic subcapsular biloma, developed after endoscopic removal of choledocholithiasis, managed with percutaneous drainage procedure and endoscopic stenting, and report with a review of literature.
Cholangiography* ; Cholangitis ; Choledocholithiasis ; Drainage ; Hemorrhage ; Humans ; Pancreatitis ; Stents

A choledochocele is a benign cyst-like herniation of the intramural segment of the distal common bile duct protruding into the duodenal lumen. Cholangiography is essential to demonstrate a choledochocele. Because choledochoceles are often associated with characteristic structual alterations of the papilla of Vater and the peripapillary area, ERCP is helpful in demonstrating a choledochocele. We present the clinical, endoscopic and radiographic (ERCP) findings in a patient with choledochocele.
Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Common Bile Duct ; Humans