>Year 2002, Issue 4
Ramírez AFJ, Rojano RME, Vasquezmellado MIP
Usefulness of transoperative video-assisted cholangiography, endoscopic aspects of the biliary tract
Cir Gen 2002; 24 (4)
PDF: 4. Kb.
Objective: To demonstrate the diagnostic and therapeutic usefulness of transoperative video-assisted cholangioscopy in patients with suspected biliary obstruction, as well as to show the endoscopic aspects of the biliary tract.
Setting: Second level health care hospital.
Design: Observational, descriptive study.
Patients and methods: Nine patients were studied, their ages ranged from 40 to 60 years, of either sex. Patients were admitted to the emergency ward of the hospital from January to June 2001 with abdominal pain at the right hypochondrium, jaundice, hyperbilirubinemia, with right predominance. The ultrasound study revealed vesicular lithiasis, a choledochus larger than 12 mm in diameter, during surgery a greater than 1 cm diameter was found. A Storz videocholangioscope with an insertion tube of 3.5 mm was used. The following variables were analyzed: cause of the obstruction, characteristics of the biliary tract, and permeability to the duodenum.
Results: Eight videocholangioscopies and one with optic fiber were performed. In five patients it was performed through the choledochotomy and in four through the cystic conduct. Visualization was completed in eight cases; four patients presented secondary biliary lithiasis; purulent material in one patient and obstruction due to fibrin in another. Access to the duodenal lumen was achieved in five patients. A calculus was extracted in one patient using a Dormia basket; in the other three, resolution was achieved by irrigation through the cholangioscope. No Catell catheter was placed, allowing for primary closure of the choledochotomy.
Conclusion: Video-assisted cholangioscopy is a useful study in the presence of biliary tract obstruction that allows knowing the shape, track, and direction of the biliary tract, as well as the cause of the obstruction and offers the possibility of extracting the calculi.
||Videocholangioscope, choledocho, biliary tract, choledochotomy.
Scotiniotis IA, Kochman ML. Intramural cyst of the bile duct demonstrated by cholangioscopy and intraductal US. Gastrointest Endosc 2001; 54: 260-2.
Tsuyuguchi T, Saisho H, Ishihara T, Yamaguchi T, Onuma EK. Long-term follow-up after treatment of Mirizzi syndrome by peroral cholangioscopy. Gastrointest Endosc 2000; 52: 639-44.
Kim HJ, Kim MH, Lee SK, Yoo KS, Seo DW, Min YI et al. Characterization of primary pure cholesterol hepatolitiasis: cholangioscopic and selective cholangiographic findings. Gastrointest Endosc 2001; 53: 324-8.
Kim HJ, Kim MH, Lee SK, Yoo KS, Seo DW, Min YI. Tumor vessel: a valuable cholangioscopic clue of malignant biliary stricture. Gastrointest Endosc 2000; 52: 635-8.
Seo WD, Kim MH, Lee SK, Myung SJ, Kang GH, Ha HK. Usefulness of cholangioscopy in patients with focal stricture of the intrahepatic duct unrelated to intrahepatic stones. Gastrointest Endosc 1999; 49: 204-9.
Tamada K, Kurihara K, Tomiyama T, Ohashi A, Wada S, Satoh Y et al. How many biopsies should be performed during percutaneous transhepatic cholangioscopy to diagnose biliary tract cancer? Gastrointest Endosc 1999; 50: 653-8.
Yan US, Kim GH, Ok CM, Lee JS, Huh J, Song CS. Percutaneous transhepatic electrohidraulic for stones in biliary tracs. Gastroenterol Korean 1998; 31: 92-9.
Huang SP, Wang HP, Chen JH, Wu MS, Shun CT, Lin JT. Clinical application of EUS and peroral cholangioscopy in a choledochocele with choledocholitiasis. Gastrointest Endosc 1999; 50: 568-71.
Moon JH, Cho YD, Ryu CB, Kim JO, Cho JY, Kim YS et al. The role of percutaneous transhepatic papillary balloon dilation in percutaneous choledochoscopic lithotomy. Gastrointest Endosc 2001; 54: 232-6.
Seo DW, Lee SK, Yoo KS, Hang GH, Kim MH, Shuh DJ et al. Cholangioscopic findings in bile duct tumors. Gastrointest Endosc 2000; 52: 630-4.
>Year 2002, Issue 4