Objective: Computerized tomography (CT) plays an important role in the diagnosis of diseases of biliary tract. Recently, three dimensions (3D) spiral CT imaging has been used in surgical diseases gradually. This study...Objective: Computerized tomography (CT) plays an important role in the diagnosis of diseases of biliary tract. Recently, three dimensions (3D) spiral CT imaging has been used in surgical diseases gradually. This study was designed to evaluate the diagnostic value of 3D spiral CT imaging of cholangiopancreatic ducts on obstructive jaundice. Methods: Thirty patients with obstructive jaundice had received B-mode ultrasonography, CT, percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP), and 3D spiral CT imaging of cholangiopancreatic ducts preoperatively. Then the diagnose accordance rate of these examinational methods were compared after operations. Results: The diagnose accordance rate of 3D spiral CT imaging of cholangiopancreatic ducts was higher than those of B-mode ultrasonography, CT, or single PTC or ERCP, which showed clear images of bile duct tree and pathological changes. As to malignant obstructive jaundice, this examinational technique could clearly display the adjacent relationship between tumor and liver tissue, biliary ducts, blood vessels, and intrahepatic metastases. Conclusion: 3D spiral CT imaging of cholangiopancreatic ducts has significant value for obstructive diseases of biliary ducts, which provides effective evidence for the feasibility of tumor-resection and surgical options.展开更多
In the last decades many advances have been achieved in endoscopy, in the diagnosis and therapy of cholangiocarcinoma, however blood test, magnetic resonance imaging, computed tomography scan may fail to detect neopla...In the last decades many advances have been achieved in endoscopy, in the diagnosis and therapy of cholangiocarcinoma, however blood test, magnetic resonance imaging, computed tomography scan may fail to detect neoplastic disease at early stage, thus the diagnosis of cholangiocarcinoma is achieved usually at unresectable stage. In the last decades the role of endoscopy has moved from a diagnostic role to an invaluable therapeutic tool for patients affected by malignant bile duct obstruction. One of the major issues for cholangiocarcinoma is bile ducts occlusion, leading to jaundice, cholangitis and hepatic failure. Currently, endoscopy has a key role in the work up of cholangiocarcinoma, both in patients amenable to surgical intervention as well as in those unfit for surgery or not amenable to immediate surgical curative resection owing to locally advanced or advanced disease, with palliative intention. Endoscopy allows successful biliary drainage and stenting in more than 90% of patients with malignant bile duct obstruction, and allows rapid reduction of jaundice decreasing the risk of biliary sepsis. When biliary drainage and stenting cannot be achieved with endoscopy alone, endoscopic ultrasound-guided biliary drainage represents an effective alternative method affording successful biliary drainage in more than 80% of cases. The purpose of this review is to focus on the currently available endoscopic management options in patients with cholangiocarcinoma.展开更多
基金Supported by a grant of Jiangxi Province Scientific Technologic Foundation (No. E990611)
文摘Objective: Computerized tomography (CT) plays an important role in the diagnosis of diseases of biliary tract. Recently, three dimensions (3D) spiral CT imaging has been used in surgical diseases gradually. This study was designed to evaluate the diagnostic value of 3D spiral CT imaging of cholangiopancreatic ducts on obstructive jaundice. Methods: Thirty patients with obstructive jaundice had received B-mode ultrasonography, CT, percutaneous transhepatic cholangiography (PTC) or endoscopic retrograde cholangiopancreatography (ERCP), and 3D spiral CT imaging of cholangiopancreatic ducts preoperatively. Then the diagnose accordance rate of these examinational methods were compared after operations. Results: The diagnose accordance rate of 3D spiral CT imaging of cholangiopancreatic ducts was higher than those of B-mode ultrasonography, CT, or single PTC or ERCP, which showed clear images of bile duct tree and pathological changes. As to malignant obstructive jaundice, this examinational technique could clearly display the adjacent relationship between tumor and liver tissue, biliary ducts, blood vessels, and intrahepatic metastases. Conclusion: 3D spiral CT imaging of cholangiopancreatic ducts has significant value for obstructive diseases of biliary ducts, which provides effective evidence for the feasibility of tumor-resection and surgical options.
文摘In the last decades many advances have been achieved in endoscopy, in the diagnosis and therapy of cholangiocarcinoma, however blood test, magnetic resonance imaging, computed tomography scan may fail to detect neoplastic disease at early stage, thus the diagnosis of cholangiocarcinoma is achieved usually at unresectable stage. In the last decades the role of endoscopy has moved from a diagnostic role to an invaluable therapeutic tool for patients affected by malignant bile duct obstruction. One of the major issues for cholangiocarcinoma is bile ducts occlusion, leading to jaundice, cholangitis and hepatic failure. Currently, endoscopy has a key role in the work up of cholangiocarcinoma, both in patients amenable to surgical intervention as well as in those unfit for surgery or not amenable to immediate surgical curative resection owing to locally advanced or advanced disease, with palliative intention. Endoscopy allows successful biliary drainage and stenting in more than 90% of patients with malignant bile duct obstruction, and allows rapid reduction of jaundice decreasing the risk of biliary sepsis. When biliary drainage and stenting cannot be achieved with endoscopy alone, endoscopic ultrasound-guided biliary drainage represents an effective alternative method affording successful biliary drainage in more than 80% of cases. The purpose of this review is to focus on the currently available endoscopic management options in patients with cholangiocarcinoma.
