Percutaneous cholangioscopy was performed on 270 patients with biliary disease at Trung Vuong Emergency Center in HCM city. The endoscope was inserted into the bile ducts through either a T-tube tract 187 cases or a percutaneous transhepatic tract 83 cases. Indications included cholelithiasis in 262 patients, common hepatic duct stricture after cholecystectomy in 3, and suspected malignant biliary obstruction in 5. Interventional maneuvers included electrohydraulic lithotripsy, extraction of stones and ascaris, dilatation of bile duct stricture, libiary cutaneous stenting, and biliary biopsy
Biliary Tract Diseases ; diagnosis ; therapeutics ;

Newly introduced direct peroral cholangioscopy and the development of video choledochoscopes have enabled more defined observation of bile duct mucosal lesions with clearer images. Narrow-band imaging (NBI) is a unique endoscopic imaging technology that provides enhanced endoscopic images of surface mucosal structures and its superficial microvessels. Advanced cholangioscopy and NBI are expected to be useful for precise evaluation and correct diagnosis of biliary tract diseases. However, the diagnostic value of advanced bile duct imaging with cholangioscopy requires further evaluation.
Bile Ducts* ; Bile* ; Biliary Tract Diseases ; Biliary Tract* ; Diagnosis ; Microvessels

There have been some differences between the manifestations of biliary tract diseases in the Korean population and those in the populations of western countries, and these differences have been varying recently. A clinical analysis of 1000 patients who had been treated surgically for biliary diseases at the Department of General Surgery, St. Benedict Hospital, during the period of 10 years from January 1986 to December 1995 was done, and the results were compared with those of previous reports. The following subjects emerged as points of variance : 1) The incidence of the each biliary tract disease, 2) In calculous biliary disease, the location of the stone and the chemical composition of the stone, 3) Parasitic biliary disease, 4) The sex ratio and the age distribution, 5) The duration of illness, 6) Common symptoms and signs and their frequency, 7) Positive laboratory findings and the availability of radiologic diagnoses, 8) Common organisms in the bacterial culture, 9) The management of biliary diseases, and 10) Postoperative complications and the mortality rate. The clinical manifestations of biliary diseases have changed gradually and have been influenced by multiple factors: improvements inf living, education, and the environment, advances in diagnostic and therapeutic methods, etc.. Although these changes are due to the influences of westernization, they should also exhibit Korean-unique charecteristics. Also, we l expect further improvements in the future, and keep in mind those different points, there should be further suitable management, depending on changing features.
Age Distribution ; Biliary Tract Diseases* ; Biliary Tract* ; Diagnosis ; Education ; Humans ; Incidence ; Mortality ; Postoperative Complications ; Sex Ratio

To investigate the diagnostic accuracy of ERCP in pancreatobiliary disease, the authors analysed the 1,244 cases of ERCP. The success rate of ERCP was 91.5%. The diagnostic accuracy of ERCP was 93.6% and complications occurred in 2.1%. Complications included pancreatitis,cholangitis and drug reactions. Among the biliary tract disease diagnosed, by ERCP, biliary tract stone was the most common finding. Compared with operative diagnosis of biliary tract stones,the sensitivity of ERCP diagnosis was 92.7% while that of sonographic diagnosis was 81.4%. The specificity of ERCP diagnosis was 94.4% while that of sonagraphic diagnosis was 80.9%. ln the diagnosis of common bile duct stones, ERCP was more accurrate than sonographic diagnosis. The results show that ERCP was a safe and effective diagnostic tool in the assessment of pancreatobiliary tract disease.
Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Diagnosis ; Sensitivity and Specificity ; Ultrasonography

To investigate the diagnostic accuracy of ERCP in pancreatobiliary disease, the authors analysed the 1,244 cases of ERCP. The success rate of ERCP was 91.5%. The diagnostic accuracy of ERCP was 93.6% and complications occurred in 2.1%. Complications included pancreatitis,cholangitis and drug reactions. Among the biliary tract disease diagnosed, by ERCP, biliary tract stone was the most common finding. Compared with operative diagnosis of biliary tract stones,the sensitivity of ERCP diagnosis was 92.7% while that of sonographic diagnosis was 81.4%. The specificity of ERCP diagnosis was 94.4% while that of sonagraphic diagnosis was 80.9%. ln the diagnosis of common bile duct stones, ERCP was more accurrate than sonographic diagnosis. The results show that ERCP was a safe and effective diagnostic tool in the assessment of pancreatobiliary tract disease.
Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde* ; Common Bile Duct ; Diagnosis ; Sensitivity and Specificity ; Ultrasonography

In 1, 345 patients suspected of having pancreatic or biliary tract disease, 23 patients were shown to have biliary ascariasis demonstrated by endseopic retrograded cholangiopancreatog raphy, at Kwang Ju Christian Hospital from Sep. 1976 to Aug. 1983. Authors report the clinical study and ERCP finding of 23 cases of biliary ascariasis. The result were as follows. 1) Out of 1,345 cases of ERCP, biliary ascariasis were 28 cases, The ascaris were found in CHD & IHD in 21 cases, and 2 casee were found in Ampulla of Vater. 2) There was no specifia age incidence and male to female ratio was 1: 1.9, 3) The disease was more prevalent in spring & summer, and more prevalent in rural area than urban area. 4) The chief eomplaints were RUQ and epigastric abdominal pain. The cases which were admitetted within 2weeks of onset were 16 cases. 5) Ascaris in biliary tract were removed by operation in 14 cases, and EST were performed in 5 cases. Two cases werere moved by DORMIA basket under the endoscopic direct visualization. 6) We report E.S.T. as a new therapeutic method of biliary ascariasis.
Abdominal Pain ; Ampulla of Vater ; Ascariasis* ; Ascaris ; Biliary Tract ; Biliary Tract Diseases ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis* ; Female ; Gwangju ; Humans ; Incidence ; Male

E.S.T. is performed not only for the treatment but also for the diagnosis of biliary tract diseases. E.S.T. serves as a diagnostic aid for some of biliary tract diseases which require such procedures as a peroral cholangioscopy or biopsy of the biliary duct for precise diagnosis and further differential diagnosis. The diseases of our patients were diagnosed by clinical findings and such diagnostic maneuvers as abdominal ultrasonography, intravenous cholangiography, percutaneous transhepatic chorangiography(P.T.C.), endoscopic retrograde chorangiopancreatography(E.R.C.P.), In all the two cases, abdominal ultrasonography revealed dilated extrahepatic duct, but biliary trees were not visualized at E.R.C.P. In one of the two cases, P.T.C. revealed a filling defect with dilated common bile ducts(CBD) but we could not make a differential diagnosis of CBD stone from CBD cancer. In another of the two cases, on which intravenous cholangiography was done, we could not see CBD. For the purpuse of precise diagnosis and further differential diagnosis, we performed EST and then ERCP thraugh widened papillae. With those procedures, CBD stones were shown.
Bile ; Biliary Tract Diseases ; Biopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diagnosis, Differential ; Humans ; Ultrasonography

Agenesis of the right lobe of the liver is an extremely rare anomaly of the liver, and few cases are reported in the literature. Most of the patients with this anomaly are accompanied by additional anormalies such as retrohepatic or suprahepatic gallbladder and other biliary tract diseases, including cholelithiasis, carcinoma of the gallbladder and portal hypertension. The diagnosis of this rare anatomical variant was established by ultrasonography and computed tomography. The radiological findings, clinical presentation, and differential diagnosis are reviewed.
Biliary Tract Diseases ; Cholelithiasis ; Diagnosis ; Diagnosis, Differential ; Gallbladder ; Humans ; Hypertension, Portal ; Liver* ; Ultrasonography

Since its introduction into clinical practice in the 1980s, endoscopic ultrasound (EUS) has been described as a good imaging modality for the diagnosis of pancreatobiliary diseases. However, differential diagnosis of certain lesions based only on B-mode ultrasound images can be challenging. Clinical use of ultrasound contrast agents has expanded the utility of EUS from that of detection to characterization of pancreatobiliary lesions based on the enhancement features of contrast-enhanced EUS (CE-EUS). Current low mechanical index techniques for CE-EUS using second-generation contrast agents have a number of distinct advantages over conventional diagnostic modalities in evaluating pancreatobiliary lesions, including real-time assessment of perfusion pattern, availability, and the absence of exposure to radiation. This article describes the technical aspects of CE-EUS and reviews the expanding indications in pancreatobiliary diseases and further development of this technique.
Biliary Tract Diseases/diagnosis/*ultrasonography ; *Contrast Media ; Diagnosis, Differential ; Endosonography/*methods ; Humans ; Medical Illustration ; Pancreatic Diseases/diagnosis/*ultrasonography

Gallbladder agenesis is a rare condition of hepatobiliary congenital anomaly. It is caused by failure of development of the caudal division of the primitive hepatic diverticulum or failure of vacuolization after the solid phase of embryonic development. It is divided into 2 groups: (1) those whose conditions are discovered clinically because of persistent symptoms and proven by abdominal exploration with operative cholangiography; and (2) those who are asymptomatic during life and whose conditions are discovered only at necropsy. If symptoms are present, they are unlikely to be related to gallbladder disease. It is impossible, at present, to make a preoperative diagnosis of gallbladder agenesis. Operative cholangiography is absolutely necessary to rule out an intrahepatic gall bladder. Confirmation at surgery and autopsy requires thorough dissection of the biliary tract and liver bed. Therefore, we presented this case with a brief review of the related literature.
Autopsy ; Biliary Tract ; Cholangiography ; Diagnosis ; Diverticulum ; Embryonic Development ; Female ; Gallbladder Diseases ; Gallbladder* ; Liver ; Pregnancy ; Urinary Bladder