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Value of endoscopic retrograde cholangiography and per cutaneous trans hepatic cholangiography with a thin needle for bile duct visualization in jaundice



Value of endoscopic retrograde cholangiography and per cutaneous trans hepatic cholangiography with a thin needle for bile duct visualization in jaundice



Gastroenterologie Clinique et Biologique 2(11): 877-882



Endoscopic retrograde cholangiographies [50] and 50 percutaneous transhepatic cholangiographies using a fine needle were performed in 91 patients with cholestatic jaundice and compared. Although endoscopic cannulation of the papilla of Vater succeeded in 82%, it visualized the biliary tree in only 76% of patients. Percutaneous transhepatic cholangiography was successful in 74%. For patients with intrahepatic cholestasis, endoscopic retrograde cholangiography was successful in 11 of 15 patients and percutaneous transhepatic cholangiography in 5 of 15 (P < 0.05). The diagnosis rate for extrahepatic cholestasis was similar with percutaneous transhepatic cholangiography [83%] and endoscopic retrograde cholangiography (83%) (including diagnosis obtained by duodenoscopy and biopsy or pancreatogram: 8%). Percutaneous cholangiography with a narrow needle is a simple, fast, cheap and suitable method, even for an unexperienced operator, to investigate the jaundiced patient, although the success rate is a little lower than with retrograde cholangiography. Endoscopic retrograde cholangiography is indicated when sphincterotomy is considered or when percutaneous transhepatic cholangiography has failed or is contra-indicated. In some patients both techniques may be usefully employed.

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Accession: 006889228

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