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 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

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

No abstract available.
*Cholangiography ; *Cholecystectomy, Laparoscopic ; Choledocholithiasis/*surgery ; *Endoscopy, Gastrointestinal ; Female ; Humans ; Male