Gut Liver.  2015 Jul;9(4):561-565. 10.5009/gnl14231.

Role of Balloon-Sheathed Intraductal Ultrasonography for Patients with Extensive Pneumobilia

• Kim HN
• Park CH
• Cho EA
• Rew SJ
• Park IH
• Lim SU
• Jun CH
• Park SY
• Kim HS
• Choi SK

• KMID: 2160642
• DOI: http://doi.org/10.5009/gnl14231

Abstract

Intraductal ultrasonography (IDUS) is one of the most useful diagnostic tools for various extrahepatic biliary diseases. However, conventional IDUS has some limitations in providing accurate cross-sectional imaging of the bile duct in patients with extensive pneumobilia. Using a balloon-sheathed catheter, the US system (balloon-sheathed IDUS) can overcome these limitations. Sixteen patients underwent balloon-sheathed IDUS during endoscopic retrograde cholangiography. The balloon-sheathed IDUS was inserted via a transpapillary route when visualization of the bile duct with conventional IDUS was distorted by extensive pneumobilia. The patient group had a mean age of 65.5 years, and 56.3% (9/16) were male. The balloon-sheathed IDUS permitted successful visualization of the bile duct in all patients, regardless of the extent of pneumobilia. Using this system, remnant common bile duct stones were detected in five patients (31.3%), and cholangiocarcinoma was detected in one patient (6.3%). The balloon-sheath IDUS aided in stone sweeping. No significant complications, including bleeding, perforation, or pancreatitis, occurred in any of the patients. The balloon-sheathed catheter US system was useful and safe for biliary IDUS in patients with extensive pneumobilia.

Keyword

Common bile duct diseases; Intraductal ultrasonography

MeSH Terms

Adult
Aged
Aged, 80 and over
Biliary Tract Diseases/*ultrasonography
Catheterization/instrumentation/methods
Cholangiopancreatography, Endoscopic Retrograde/instrumentation/*methods
Endosonography/instrumentation/*methods
Female
Humans
Male
Middle Aged
Retrospective Studies
Ultrasonography, Interventional/instrumentation/*methods