Gut Liver.  2011 Sep;5(3):377-379.

Early Bile Duct Cancer Detected by Direct Peroral Cholangioscopy with Narrow-Band Imaging after Bile Duct Stone Removal

• Kim HK
• Moon JH
• Choi HJ
• Kim HK
• Min SK
• Park JK
• Cho YD
• Park SH
• Lee MS

Abstract

Cholangioscopy not only enables the direct visualization of the biliary tree, but also allows for forceps biopsy to diagnosis early cholangiocarcinoma. Recently, some reports have suggested the clinical usefulness of direct peroral cholangioscopy (POC) using an ultra-slim endoscope with a standard endoscopic unit by a single operator. Enhanced endoscopy, such as narrow band imaging (NBI), can be helpful for detecting early neoplasia in the gastrointestinal tract and is easily applicable during direct POC. A 63-year-old woman with acute cholangitis had persistent bile duct dilation on the left hepatic duct after common bile duct stone removal and clinical improvement. We performed direct POC with NBI using an ultra-slim upper endoscope to examine the strictured segment. NBI examination showed an irregular surface and polypoid structure with tumor vessels. Target biopsy under direct endoscopic visualization was performed, and adenocarcinoma was documented. The patient underwent an extended left hepatectomy, and the resected specimen showed early bile duct cancer confined to the ductal mucosa.

Keyword

Early bile duct cancer; Direct peroral cholangioscopy; Narrow band imaging

MeSH Terms

Adenocarcinoma
Bile
Bile Duct Neoplasms
Bile Ducts
Biliary Tract
Biopsy
Cholangiocarcinoma
Cholangitis
Common Bile Duct
Endoscopes
Endoscopy
Female
Gastrointestinal Tract
Hepatectomy
Hepatic Duct, Common
Humans
Middle Aged
Mucous Membrane
Narrow Band Imaging
Surgical Instruments