In a jaundiced patient, it is important to ascertain as early as possible whether the bile duct is dilated. Ultrasonography, computed tomography & conventional cholangiography are widely accepted methods of determining the size of the extrahepatic bile ducts. But there is a considerable discrepancy among the size of the bile duct as measured from them. So the author analyzed and compared the respective diameters of the bile ducts in Korean normal adults as measured from cadaver, IV cholangiography, ultrasoud and computed tomography. The materials were 45 cases of cadaver, 38 cases of IV cholangiography, 100 cases of ultrasonography & 55 cases of computed tomography. The results were as follows ; 1. The diameters of the bile ducts were 7.58±2.26mm at CHD & 8.04±2.42mm at CBD from cadaver ; 5.38±1.90mm at CHD & 6.58±2.37mm at CBD from IV cholanglography ; 3.24±1.13mm at CHD & 4.71±1.48mm at CBD from ultrasonography ; and 4.56±1.51mm at CHD & 5.87±1.68mm at CBD from computed tomography. 2. The diameter of the bile duct was greatest in cadaver, and then reduced in IV cholangiography, computed tomography and ultrasonography in this orde.r 3. There were no size discrepancy between the diameter of the common hepatic duct and that of the common bile duct. 4. There were no discrepanry of the diameter of the bile duct by sex.
Adult* ; Bile Ducts* ; Bile Ducts, Extrahepatic ; Bile* ; Cadaver ; Cholangiography ; Common Bile Duct ; Hepatic Duct, Common ; Humans ; Ultrasonography

Primary carcinoma of the bile ducts is an uncommon lesion that is difficult to diagnosis in early stage. Correct diagnosis with determination of site and extent of the carcinoma is essential for proper management. Authors presented 35 cases of bile duct carcinoma, confirmed at Seoul National University Hospital from 1978 to 1981, and analyzed their clinical and radiological findings. The results were as follows; 1. The 6th decade was the predilection age, and the ratio of male to female was 4:3. 2. The locations of bile duct carcinomas were common bile duct in 31%, porta hepatis in 26%, junction in 17%, diffuse involvement in 17%, and common hepatic duct in 9% in order of frequency. 3. Ultrasonography was done in 31 cases. Dilatation of intrahepatic ducts was noticed in 28 cases. Among the 28 cases, correct diagnosis as bile duct carcinoma were made in 5 cases. Proximal obstructive patterns were observed in 14 cases and distal obstructive patterns in 9 cases. 4. ERCP was done in 15cases. Successful studies of ERCP were done in 8 cases of them. Among the cases, diagnosis as bile duct carcinoma were made in 4 cases. 5. PTC was done in 20 cases and successful in all of them. Correct diagnosis as bile duct carcinoma were made in 16 cases and the diagnostic accuracy was 80%.
Bile Ducts ; Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Dilatation ; Female ; Hepatic Duct, Common ; Humans ; Male ; Seoul ; Ultrasonography

BACKGROUND/AIMS: Common bile duct stones are the most common among bile duct diseases. In the past, common bile duct stones were considered a surgically operable disease, but is now considered a medical disease due to the advancement of endoscopy and endoscopic techniques. The aim of this study was to determine the results of endoscopic treatment of common bile duct stones. METHODS: Removal of primary or secondary common bile duct stones were attempted by peroral or percutaneous endoscopy. The common bile duct stones were diagnosed by ultrasonography or cholangiography. As a primary approach route, the peroral transpapillary endoscopic approach was tried. On the other hand, percutaneous common bile duct stone removal was attempted if the patient already had a percutaneous route, peroral transpapillary approaches failed, or if conditions for endoscopy were unfavorable. RESULTS: The study subjects consisted of 196 patients; 96 males and 100 females. The mean age was 61.8 years. A total of 272 endoscopic stone removal were attempted in 196 patients. Of the 272, peroral approaches were conducted 241 times for 183 patients, and percutaneous approaches were performed 31 times for 12 patients. The success rate of the first treatment modality to remove the common bile duct stones was 90.3% (176/195). The overall success rate of endoscopic common bile duct stones removal was 100%. CONCLUSIONS: In all patients, the common bile duct stones were removed successfully by endoscopy, and thus supporting the shift of recognizing common bile duct stones as a medical rather than surgical discase.
Bile Duct Diseases ; Cholangiography ; Chymopapain ; Common Bile Duct* ; Endoscopy ; Female ; Hand ; Humans ; Male ; Ultrasonography

Primary carcinoma of the bile duct is uncommon but not rare and its prognosis is poor even though long-termsurvival had been reported. The authors presented 62 cases of bile duct cancer, which were confirmed at YUMC fromJan. 1971 to Dec. 1981. The results were as follows; 1. The most prevalent age group was 6th decade and a male-tofemale ratio was 1.9:1. 2. Jaundice was the most common clinical manifestations(84%), and followed by right
Bile Duct Neoplasms ; Bile Ducts ; Bile ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Diagnosis ; Dilatation ; Hepatomegaly ; Humans ; Jaundice ; Prognosis ; Ultrasonography

The authors analysed retrospectively 56 cases of bile duct cancer, which were confirmed by histologically in47 cases and highly suuspected by clinically and radiologically in 9 cases. The resutls were as follows: 1. Themost prevalent age groups were 5th decade and a male to female ratio is 2.7:1. 2. The location of bile ductcarcinomas were common bile duct in 36%, common hepatic duct in 25%, junction in 13%, porta haptis in 11% anddiffuse involvement in 5%. 3. The accuracy of predicting obstruction is by ultrasonography was 76%. 4. Correctdiagnosis as bile duct carcinoma was made in 29 cases(43%). 5. The echogenicity of bile duct carcinoma compare toliver parenchyme was hyperechoic in 10 cases(34.5%), isoechoic in 14 cases(48.3%) and hypoechoic in 5cases(17.2%). 6. Posterior acoustic shadowing was seen in 5 cases. 7. The shape of obstruction site was abruptcut-off in 12 cases(41%), funnel shape in 7 cases(24%) and indistinct in 10 cases(35%).
Acoustics ; Bile Duct Neoplasms ; Bile Ducts ; Bile ; Biliary Tract ; Common Bile Duct ; Female ; Hepatic Duct, Common ; Humans ; Male ; Retrospective Studies ; Shadowing (Histology) ; Ultrasonography

In the diagnosis of bile duct carcinoma, oral or intravenous cholangiography is of no air in the majority ofpatients with bile duct carcinoma who are jaundiced. Recently ultrasonography and CT are widely used for evalutionof biliary disease, but direct visualizing methods of the biliary tract by ERCP and PTC gives more detailed information and exact localization of the lesion. ERCP is less invasive and dangerous and has some more advantages than PTC. We analyzed 33 cases of confirmed extrahepatic bile duct caracinoma who were performed ERCP. The resultswere as follows; 1. The 7th decade was the predilection age, and the radio of male to female was 3.:1. 2. Thelocations of extrahepatic bile duct carcinomas were common bile duct in 45.5%, common hepatic duct in 27.3%,junction of cystic duct and widely extended in 12.1% respectively and junction of hepatic duct in 3.05 in order offrequency. 3. ERCP finding of extrahepatic bile duct carcinomas revealed complete obstruction of bile duct in mostcases, and irregular margined protuberant type was more common than smooth margined constricted type atobstruction site. 4. ERCP finding according to the location of lesion showed that protuberant type was relativelyfrequent in common bile duct and constircted type in common hepatic duct respectively.
Bile Ducts ; Bile Ducts, Extrahepatic ; Biliary Tract ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Female ; Hepatic Duct, Common ; Humans ; Male ; Ultrasonography

Follow-up sonographic studies of three infants, whose initial sonograms showed findings suggestive of choledochal cyst, demonstrated disappearance of cystic dilatation of the common bile ducts. The phenomena could be accounted for by acute common bile duct obstruction secondary to bile sludge. Bile plug syndrome should also be included in the differencial diagnosis. When a cystic or fusiform dilatation of the common bile duct is seen on sonogram. Conservative management must be the choice of approach unless the finding is proven to unchanged over a period of time and irreversible.
Bile ; Choledochal Cyst ; Common Bile Duct* ; Diagnosis ; Dilatation* ; Follow-Up Studies ; Humans ; Infant* ; Sewage ; Ultrasonography

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

Congenital anomaly of the extrahepatic biliary system is relatively common, especially vascular variations are much more frequent than anatomic variations. The normal anatomical structure is encountered in only 35 percent of individuals, many of these variations have little or no clinical improtance, but some cases induce symptoms and signs or may lead to incorrect diagnosis and inappropriate management. These are very important to correct diagnosis of biliary variations observed during ultrasonography, cholangiography and endoscopic retrograde cholangiopancreatography(ERCP) and to accurate management by surgeon or endoscopist since accidental section or ligation of aberrant structures can lead to serious complications. We experienced a very rare case of extrahepatic bile duct anomaly confirmed by ERCP. The right and left extrahepatic ducts were connected at the level of the pancreatic segment of the common bile duct and the cystic duct drains to the right extrahepatic duct. There were several stones in the distal portion of the left extrahepatic duct and gallbladder.
Bile Ducts, Extrahepatic* ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Choledocholithiasis ; Common Bile Duct ; Cystic Duct ; Diagnosis ; Gallbladder ; Ligation ; Ultrasonography

Ultrasonography is a predominantly accurate, relatively simple unique diagnsotic method of obstructive jaundice. The ultrasonographic findings of obstructive jaundice are dilated intra- and extrahepatic duct with intraluminal hyperreflective echo or mass in and/or around the bile duct. The superiority of high resolution real time ultrasonography for the diagnosis of obstructive jaundice is based on the easy detectability of extra-and intrahepatic bile ducts by its multiple sectional images in a short time, the flexibility of probe and the small crystal size. Author evaluated real time sonographic findings 46 obstructive jaundice patients confirmed by surgery or radiographical examinations. The results were: 1. Diameter of extrahepatic duct in obstructive jaundice were varied from normal to 4.0 cm, mostly 8 to 10 mm in diameter (26%). Degree of dilatation of biliary duct appeared more prominent in cancer patients than any other causes of obstruction. 2. The site of obstruction was detected in85% (39/46) and its common site was common bile duct in 63% (29/46). 3. The diagnostic accuracy of choledocholithiasis and cancer was 82% (22/27) and 44% (4/9), respectively. Diagnostic accuracy of the real time ultrasonography in obstructive jaundice was over all 75% (34/46).
Bile Ducts ; Bile Ducts, Intrahepatic ; Choledocholithiasis ; Common Bile Duct ; Diagnosis ; Dilatation ; Humans ; Jaundice, Obstructive ; Methods ; Pliability ; Ultrasonography