Imaging of the Biliary and Pancreatic Ducts

Okuda, Kunio; Tsuchiya, Yukihiro; Saisho, Hiromitsu

doi:10.1159/000171082

Cited by 1 publication

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“…Without PTC, a drainage catheter is introduced under US guidance [9] into a dilated bile duct to effect good drainage. PTC should be avoided before biliary decompression because it may cause cholangitis [10][11][12]. If necessary, ERCP is combined to determine the exact extent of malignant invasion.…”

Section: Pereutaneous Transhepatic Cholangiographymentioning

confidence: 99%

The role of ultrasound, percutaneous transhepatic cholangiography, computed tomographic scanning, and magnetic resonance imaging in the preoperative assessment of bile duct cancer

1988

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The diagnosis of bile duct carcinoma currently depends largely on radiographic imaging. Imaging provides certain information that is necessary for determining operability and the proper surgical procedure to be employed. In an early stage of bile duct carcinoma, elevated serum enzymes may be the only abnormality detectable, but once the mass has grown to cause sufficient stenosis along the biliary tract, serum bilirubin starts to rise. Differentiation of intra-and extrahepatic cholestases is the primary task of the gastroenterologist. The site and nature of the obstructing lesion must then be determined by means of imaging. This article deals mainly with the diagnosis of dile duct carcinoma through imaging, excluding the endoscopic procedure. UltrasonographyUltrasonography (US) should be the first procedure used in patients with suspected obstructive jaundice [1][2][3][4][5]. It should be performed on the patient's first visit to the hospital or to the gastroenterologist/hepatologist. In the hands of skilled sonographers, dilatation of the biliary tract above the obstructive lesion is found with relative ease. In an early stage of the disease, however, dilatation may be confined to the extrahepatic biliary system without involvement of the intrahepatic biliary tree since the latter is protected by thick liver tissue which prevents dilatation in some measure. If the lesion is below the origin of the cystic duct, the gallbladder is enlarged and readily seen by US.Ultrasound examination of the common bile duct may not always be successful due to frequent interference by bowel gas; however, repeated examinations will eventually allow the examiner to see the lesion or to determine the approximate level of obstruction along the biliary tract.

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Section: Pereutaneous Transhepatic Cholangiographymentioning

confidence: 99%