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J Korean Radiol Soc. 1988 Oct;24(5):869-877. Korean. Original Article.
Lee MG , Cho WS , Han SS , Lee SW , Han CY .

A retrospective review of 260 patients with biliary obstruction was performed. 10 cases of biliary obstruction caused by enlarged hepatic lymph node group were analyzed focusing mainly on their levels of obstruction and the comparisons of diagnostic accuracies among sonography, transhepatic cholangiography(THC), and/or CT in spite ofour limited numbers of cases. Upper hepatic lymph node group was the most common site of obstruction by nodal metastases(7/10), and cystic node was involved in 2 and lower hepatic lymph node group was in 1 patient, who haddual sites of obstruction in common hepatic and common bile duct level. In 70 percentage of cases showing biliary dilatation, single or multiple hepatic metastatic nodules were found. The accuracy of sonography for precise levelwas 28.6% and that of CT was 75%, and that of direct cholangiography was 100%. In spite of its low accuracy authors recommend sonography as a initial diagnositic tool in the approach of jaundiced patients, who were knownto have malignant primary tumors, for it is easier to perform and has many well-known advantages. And the accuracywill be heightened by more concerned evaluation of extrahepatic bile duct.

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