Gut Liver.  2015 Jul;9(4):540-546. 10.5009/gnl14200.

Intraductal Ultrasonography without Radiocontrast Cholangiogram in Patients with Extrahepatic Biliary Disease

• Lim SU
• Park CH
• Kee WJ
• Lee JH
• Rew SJ
• Park SY
• Kim HS
• Choi SK
• Rew JS

• KMID: 2160639
• DOI: http://doi.org/10.5009/gnl14200

Abstract

BACKGROUND/AIMS
Intraductal ultrasonography (IDUS) has been performed as an adjunct to endoscopic retrograde cholangiography (ERC) during radiocontrast cholangiography (RC). Radiation exposure during RC poses a health risk to both patients and examiners. We evaluated the feasibility of IDUS without RC in various extrahepatic biliary diseases.
METHODS
IDUS was performed with the insertion of an IDUS probe from the papilla of Vater to the confluent portion of the common hepatic duct without fluoroscopy. The technical success rate and procedure-related complications were evaluated retrospectively.
RESULTS
Wire-guided IDUS without RC was performed in 105 patients. The mean age was 66.5 years, and 50 (47.6%) were male. The IDUS diagnoses included choledocholithiasis (73, 69.5%), benign biliary stricture (11, 10.5%), choledocholithiasis with biliary pancreatitis (9, 8.6%), bile duct cancer (5, 4.8%), pancreatic cancer (1, 0.9%), and others (6, 5.7%). After IDUS, 66 (62.8%) underwent stone removal, 19 (18.1%) underwent biliary drainage, and 7 (6.6%) underwent brush cytology and biopsy. No significant complications such as perforation or severe pancreatitis occurred.
CONCLUSIONS
IDUS without RC was a feasible and safe approach in patients with various extrahepatic biliary diseases. We anticipate a potentially important role of IDUS in various ERC procedures because it lacks the hazards of RC.

Keyword

Intraductal ultrasonography; Radiocontrast cholangiography; Endoscopic retrograde cholangiography

MeSH Terms

Adult
Aged
Aged, 80 and over
Bile Ducts, Extrahepatic/pathology/*ultrasonography
Biliary Tract Diseases/*ultrasonography
Cholangiopancreatography, Endoscopic Retrograde/adverse effects/*methods
Contrast Media
Drainage/methods
Endosonography/*methods
Female
Humans
Male
Middle Aged
Pancreatitis/ultrasonography
Retrospective Studies
Treatment Outcome
Ultrasonography, Interventional/*methods
Contrast Media