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A Study of Malignant Bile Duct Stenosis Using Percutaneous Transhepatic Cholangioscopy
Author(s) -
NISHIKAWA Kunihisa,
OGAWA Satoshi,
SATO Masahiro,
HOSHI Hajime,
OHASHI Shigeki,
YOSHIOKA Hideki,
MAETANI Iruru,
IGARASHI Yoshinori,
FUJINUMA Sumio,
SAKAI Yoshihiro
Publication year - 1991
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1991.tb00285.x
Subject(s) - medicine , major duodenal papilla , carcinoma , stenosis , pathology , common bile duct , bile duct , biopsy , bile duct carcinoma , radiology , gastroenterology
From June, 1987 to November, 1989, 11 patients with malignant bile duct stenosis, which was later confirmed by surgery or autopsy, were examined by percutaneous transhepatic cholangioscopy (PTCS) and by an endoscopic biopsy. The endoscopic findings obtained with the usual observation methods and methylene blue staining and the histological findings of the biopsy specimens were compared. A fine vascular proliferation was seen in all of the patients and a granular appearance was noted in patients with carcinoma of the major papilla. The papillary appearance was noted in one case each of pancreatic carcinoma, bile duct carcinoma and carcinoma of the major papilla. Marginal protrusion was not noted in patients with pancreatic carcinoma. A distorted narrow segment was seen only in cases of pancreatic carcinoma. The presence of a granular appearance indicated that the carcinoma was exposed on the surface. A high degree of fine vascular proliferation and a papillary appearance tended to indicate a carcinoma which invaded mainly into the fibromuscular layer without invasion of the mucosa. The methylene blue staining method was simple and effective for better visualization of the surface structure of the abnormal area, normal mucosa and the border zone.