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Endoscopic retrograde cholangiography using a balloon catheter the value in hepatic duct investigation



Endoscopic retrograde cholangiography using a balloon catheter the value in hepatic duct investigation



Stomach & Intestine (Tokyo) 16(11): 1259-1265



In 7 patients whose hepatic duct was not visible by standard endoscopic cholangiography with a 5 French (F) catheter, hepatic duct filling was attempted by injection of a contrast medium using a large caliber catheter, a 7 F catheter and an end-hole balloon catheter passed through a duodenoscope. The reasons for poor visualization were: an overflow of contrast medium through a patulous sphincter in 2 patients, the endoscopic sphincterotomy orifice in 3, the sphincteroplasty orifice in 1 and the cholecystoduodenostomy orifice in 1. Cholangiography with a 7 F catheter showed indefinite findings, suggesting the possible presence of hepatic duct stones in 4 patients. Stones were clearly visualized with the balloon catheter in 3 of these patient. In another patient, an obstruction of the left hepatic duct associated with rigidity and irregularity of the bile duct was also demonstrated. It was due to carcinoma. Endoscopic retrograde cholangiograpy with a balloon catheter is of much benefit to the diagnosis of hepatic lesions, especially in cases of poor filling or bile duct stenosis. This method can well visualize the hepatic ducts even in cases of pneumobilia. It is apparently essential for the diagnosis of retained or recurrent stones. This new method would provide great help in the diagnosis of hepatobiliary and pancreatic diseases.

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Accession: 005359536

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