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The role of endoscopic retrograde cholangiopancreatography in preoperative assessment of bile duct cancer
- Source :
- World Journal of Surgery. 12:27-32
- Publication Year :
- 1988
- Publisher :
- Springer Science and Business Media LLC, 1988.
-
Abstract
- A total of 73 patients with carcinoma of the bile duct (59 patients) or duodenal papilla (14 patients) were reviewed with regard to the role of endoscopic retrograde cholangiopancreatography (ERCP) in preoperative assessment of these diseases. Percutaneous transhepatic cholangiography was preferred in most of the jaundiced patients and ERCP was performed after establishment of percutaneous or operative drainage above the obstruction. Pancreatography obtained in 19 patients with bile duct carcinoma revealed pancreatic invasion in 2 patients, and chronic pancreatitis in 1 patient. Other patients with normal pancreatograms included 2 patients whose initial diagnosis had been pancreatic cancer. The extent of bile duct carcinoma could be determined in 92% of 26 patients who had retrograde cholangiography, whereas it was known preoperatively in only 27% of 33 patients in whom retrograde cholangiography was not obtained. Combined use of antegrade and retrograde cholangiography performed in 13 patients was particularly useful to clearly delineate the lesion. In most of the patients with ampullary carcinoma, biopsy during ERCP confirmed the diagnosis preoperatively; 3 of these patients underwent ERCP with a different diagnosis. Biopsy after sphincterotomy revealed bile duct carcinoma in 2 patients in whom bile duct cancer was not suspected. Complications included 2 cases of cholangitis and 2 cases of mild pancreatitis. ERCP does not provide sufficient information as to the proximal bile duct anatomy and extent of the lesion, which are essential for appropriate surgical treatment. If used with precautions to prevent possible septic complications, however, it is useful in excluding pancreatic diseases by pancreatography, in specifying the distal bile duct, and in observing the duodenum and papilla. The use of several ERCP-derived techniques such as perendoscopic biopsy, sphincterotomy, and balloon catheter cholangiography substantially increases the diagnostic utility of this procedure.
- Subjects :
- Male
Ampulla of Vater
medicine.medical_specialty
medicine.medical_treatment
Common Bile Duct Neoplasms
Bile Duct Carcinoma
Percutaneous transhepatic cholangiography
digestive system
Bile duct cancer
Adenoma, Bile Duct
Cholangiography
Preoperative Care
Humans
Medicine
Cholangiopancreatography, Endoscopic Retrograde
Endoscopic retrograde cholangiopancreatography
medicine.diagnostic_test
business.industry
Bile duct
Middle Aged
medicine.disease
Pancreatic Neoplasms
Major duodenal papilla
medicine.anatomical_structure
Bile Duct Neoplasms
Pancreatitis
Female
Surgery
Radiology
business
Subjects
Details
- ISSN :
- 14322323 and 03642313
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- World Journal of Surgery
- Accession number :
- edsair.doi.dedup.....9bbb746e1328610979397c8f1cb35707