Experience with percutaneous transhepatic cholangioscopy (PTCS) in the management of biliary tract disease

Simon, Timothy M.; Fink, Aaron S.; Zuckerman, Alan M

doi:10.1007/pl00009620

Cited by 16 publications

(8 citation statements)

References 17 publications

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“…Nimura [10] reported that a PTCS-directed biopsy had a sensitivity of 96% for diagnosing cholangiocarcinoma. These results are significantly better than those reported for fluoroscopically guided biopsies [9]. In the present case, the lesion was too small to be detected on abdominal CT.…”

Section: Discussioncontrasting

confidence: 78%

“…Since first introduced by Takada et al in 1974 PTCS has been utilized to manage a variety of biliary tract disorders [9]. The introduction of small-caliber flexible cholangioscopes in 1976 by Yamakawa et al further enhanced the application of this technique [9].…”

Section: Discussionmentioning

confidence: 99%

“…The introduction of small-caliber flexible cholangioscopes in 1976 by Yamakawa et al further enhanced the application of this technique [9]. PTCS has been used to manage diverse biliary tract disorders, including intrahepatic calculi removal, dilatation of intrahepatic biliary strictures, and the evaluation of suspected bile duct cancers [9]. Several reports have suggested that PTCS can improve biopsy accuracy [8-10].…”

Section: Discussionmentioning

confidence: 99%

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A Case of Adenocarcinomain situof the Distal Common Bile Duct Diagnosed by Percutaneous Transhepatic Cholangioscopy

Yang

Kim

Chun

et al. 2012

Korean J Intern Med

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Extrahepatic cholangiocarcinoma is often clinically challenging to diagnose. Even multidisciplinary approaches which include computed tomography, magnetic resonance imaging, and endoscopic retrograde cholangiography are unsatisfactory in some cases, especially with biliary stricture. Percutaneous transhepatic cholangioscopy (PTCS) with its direct visualization for biopsy appears to be a promising technique for detecting cholangiocarcinoma at an early stage. We report a case of adenocarcinoma in situ of the distal common bile duct (CBD) that was confirmed by PTCS. This case suggests the useful role of PTCS in the differential diagnosis of a distal CBD obstruction, particularly when other diagnostic modalities do not provide definitive information.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Case of Adenocarcinomain situof the Distal Common Bile Duct Diagnosed by Percutaneous Transhepatic Cholangioscopy

Yang

Kim

Chun

et al. 2012

Korean J Intern Med

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“…8 Complications included trapped/broken basket, 9 traction wire fracture, 10 broken handle, 11 and perforation/duct injury. 12 The majority of complications related to intracorporeal lithotripsy were associated with (the process of) gaining pancreaticobiliary access (e.g., ERCP or percutaneous transhepatic access) and included pancreatitis, hemorrhage, perforation, and sepsis. Traditionally the treatment approach to these complications has been surgical.…”

Section: ) Intracorporeal Modalitiesmentioning

confidence: 99%

How Should Biliary Stones be Managed?

Shim¹

2010

Gut Liver

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Minimally invasive therapy is currently invaluable for the treatment of biliary stones. Clinicians should be familiar with the various endoscopic modalities that have been evolving. I reviewed the treatment of biliary stones from the common practice to pioneering procedures, and here I also briefly summarize the results of many related studies. Lithotripsy involves procedures that fragment large stones, and they can be roughly classified into two groups: intracorporeal modalities and extracorporeal shock-wave lithotripsy (ESWL). Intracorporeal modalities are further divided into mechanical lithotripsy (ML), electrohydraulic lithotripsy, and laser lithotripsy. ESWL can break stones by focusing high-pressure shock-wave energy at a designated target point. Balloon dilation after minimal endoscopic sphincterotomy (EST) is effective for retrieving large biliary stones without the use of ML. Peroral cholangioscopy provides direct visualization of the bile duct and permits diagnostic procedures or therapeutic interventions. Biliary stenting below an impacted stone is sometimes worth considering as an alternative treatment in elderly patients. This article focuses on specialized issues such as lithotripsy rather than simple EST with stone removal in order to provide important information on state-of-the-art procedures. (Gut Liver 2010;4:161-172

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“…The cholangioscope's tip is lubricated and advanced into the biliary system through a 12F sheath placed through a preexisting mature (3-4 weeks) percutaneous tract. 49,50 After advancement to the duodenum or surgical anastomosis, the wire is removed for intraductal examination. The tract through which the sheath enters the liver predetermines the ducts that can be accessed with the cholangioscope; maneuvering to the opposite liver segment may be impossible through a single percutaneous tract.…”

Section: Percutaneous Cholangioscopymentioning

confidence: 99%