Background: The utility of magnetic resonance cholangiography for assessment of longitudinal tumor extension of hilar cholangiocarcinoma was investigated with reference to findings by percutaneous transhepatic cholangioscopy.
Methods: Ninety-nine patients with hilar cholangiocarcinoma underwent both magnetic resonance cholangiography and percutaneous transhepatic cholangioscopy. Longitudinal tumor extension was described with the Bismuth-Corlette classification. Hilar cholangiocarcinoma was classified morphologically into stenotic, diffuse sclerosing, and polypoid types based on selective cholangiographic findings obtained during percutaneous transhepatic cholangioscopy. Agreement between percutaneous transhepatic cholangioscopy and magnetic resonance cholangiography according to the Bismuth-Corlette classification was compared. The degree of agreement between magnetic resonance cholangiography and percutaneous transhepatic cholangioscopy according to each morphologic type was also compared in each subgroup without reference to Bismuth-Corlette type.
Results: The overall agreement between magnetic resonance cholangiography and percutaneous transhepatic cholangioscopy with regard to Bismuth-Corlette types was 87.9% (kappa = 0.832, p < 0.01). The agreement of magnetic resonance cholangiography for each Bismuth-Corlette type with reference to percutaneous transhepatic cholangioscopy was as follows: type I (n = 18), 16/18 (88.9%); type II (n = 16), 14/16 (87.5%); type IIIa (n = 23), 19/23 (82.6%); type IIIb (n = 14), 14/14 (100%); and type IV (n = 28), 24/28 (85.7%). The overall agreement between magnetic resonance cholangiography and percutaneous transhepatic cholangioscopy for Bismuth-Corlette type according to selective cholangiographic findings was as follows: stenotic type, 58/61 (95.1%, kappa = 0.929, p < 0.01); diffuse sclerosing type, 12/16 (75%, kappa = 0.619, p < 0.01); and polypoid type, 17/22 (77.3%, kappa = 0.696, p < 0.01).
Conclusion: There is good overall agreement between magnetic resonance cholangiography and percutaneous transhepatic cholangioscopy on longitudinal extension of hilar cholangiocarcinoma. Especially for the stenotic type of hilar cholangiocarcinoma (based on selective cholangiographic findings), magnetic resonance cholangiography may replace percutaneous transhepatic cholangioscopy in the determination of longitudinal tumor extension. For polypoid or diffuse sclerosing types, however, percutaneous transhepatic cholangioscopy is required for accurate evaluation of longitudinal tumor extension.
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http://dx.doi.org/10.1067/mge.2002.125363 | DOI Listing |
Cureus
December 2024
Gastroenterology and Hepatology, Monmouth Medical Center, Long Branch, USA.
Lemmel syndrome involves a periampullary duodenal diverticulum (PAD), a pouch-like outpouching near the ampulla of Vater, compressing the common bile duct. We describe a case of severe abdominal pain in a patient who had a large periampullary diverticulum, managed with surgical intervention after an initial failed endoscopic retrograde cholangiopancreatography (ERCP). An elderly female patient in her early 90s arrived at the emergency department with severe cramping pain localized to the right upper quadrant of her abdomen, progressively intensifying over several weeks.
View Article and Find Full Text PDFCurr Probl Cardiol
January 2025
International arrhythmia center, Fundacion cardioinfatil - La Cardio, Division of Cardiology, Bogota, Colombia. Electronic address:
Introduction: Electrophysiologic (EP) procedures are typically performed via the femoral venous system, but in some patients, the inferior vena cava (IVC) is unavailable. The hepatic vein has emerged as a viable alternative to femoral access, providing an inferior route that accommodates large sheaths required for better catheter manipulation. Although the percutaneous transhepatic approach has been used successfully in the pediatric population, its use in adults is scarce, with a complication rate of approximately 5%.
View Article and Find Full Text PDFPurpose: To explore the evaluation value of contrast enhanced ultrasound (CEUS) quantitative parameters in ischemic-type biliary lesions after liver transplantation to assist its early-diagnosis.
Methods: Patients who underwent liver transplantation and intravenous CEUS at Beijing Friendship Hospital, Capital Medical University from June 25, 2020 to December 28, 2022 and were diagnosed with Ischemic-type biliary lesions (ITBLs) by Magnetic Resonance Cholangiopancreatography (MRCP) or Endoscopic Retrograde Cholangiopancreatography (ERCP) or Percutaneous Transhepatic Cholangiography (PTC) were prospectively enrolled. SonoLiver software was used to quantitatively analyze the contrast images, transplanted livers with normal biliary tracts as the control group.
Sci Rep
January 2025
Department of Radiology and Nuclear Medicine, University Hospital Brno, Brno, 625 00, Czechia.
Biliary drainage is then one of the necessary procedures to help patients suffering from icterus to reduce serum bilirubin levels and relieve symptoms. The aim of this study was identifying risk factors for survival in patients with cholangiocarcinoma (CCA) treated with percutaneous transhepatic biliary drainage (PTBD) and to develop a simple scoring system predicting survival from PTBD insertion. This single-centre retrospective study included 175 consecutive patients undergoing PTBD for extrahepatic CCA (perihilar and distal).
View Article and Find Full Text PDFRofo
January 2025
Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany.
To evaluate the feasibility of liver tract embolization after transhepatic biliary drainage using a biodegradable polymer plug (IMPEDE-FX, Shape Memorial Medical, Santa Clara, CA, USA).In a retrospective observational study, 15 plug embolizations were performed in 13 patients at risk for tract-related adverse events (AEs). Risk factors included coagulopathy, cirrhosis, central bile duct puncture, previous drain-related bleeding, malignant obstruction, large tract diameter, or multilevel strictures.
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