Korean J Gastroenterol.  2006 Dec;48(6):415-420.

Intraductal Ultrasonography for the Selection of Self Expandable Metal Stent in Extrahepatic Bile Duct Carcinoma

• Yoon HG
• Kang JH
• Lee EJ
• Moon JH
• Kim SG
• Gheon YK
• Kim YS
• Cho YD
• Lee JS
• Lee MS
• Park SJ
• Lee HK
• Shim CS
• Kim BS

Abstract

BACKGROUND/AIMS: Endoscopic stent insertion with self expandable metal stent (SEMS) is one of the standard palliative treatments for the patients with unresectable bile duct carcinoma. The aim of this study was to determine whether detection of longitudinal spread of extrahepatic bile duct carcinoma by intraductal US (IDUS) would be helpful in the selection of metal stent for the palliative drainage in bile duct carcinoma. METHODS: Seventeen patients with histologically proven unresectable extrahepatic bile duct carcinoma who underwent endoscopic retrograde cholangiography with IDUS were included. Longitudinal cancer extension along the bile duct was determined and, then, compared with the cholangiographic image. The type and length of SEMS was selected based on IDUS findings. RESULTS: IDUS demonstrated more extensive tumor spread than ERC in 7 of 17 (41.2%) patients with the hepatic side of strictures and in 7 of 16 (43.8%) patients with the duodenal side of strictures. Five of 17 (29.4%) patients have changed the plan of endoscopic biliary drainage with SEMS after IDUS. There was no early dysfunction associated with endoscopic biliary drainage. CONCLUSIONS: IDUS prior to biliary drainage would be useful in demonstrating longitudinal extension of extrahepatic bile duct carcinoma. It has a potential role in helping stent selection and identifying factors which predict early stent dysfunction.

Keyword

Ultrasonography; Intraductal; Bile duct carcinoma; Metal stent

MeSH Terms

Bile Duct Neoplasms/*surgery/ultrasonography
Bile Ducts, Extrahepatic/*surgery/*ultrasonography
Carcinoma/*surgery/ultrasonography
Cholangiopancreatography, Endoscopic Retrograde
Drainage/methods
Female
Humans
Male
*Stents