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KMID : 0614619950270040463
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Korean Journal of Gastroenterology
1995 Volume.27 No. 4 p.463 ~ p.470
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Usefulness of Percutaneous Transhepatic Cholangioscopy(PTCS) in Diseases of the Biliary Tract
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이성구
최호순/김명환/서동진/민영일/성규보/권태원/이승규/민병철
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Abstract
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Background/Aims:
@EN The development of PTCS is related to the development of percutaneous trans-hepatic biliary drainage (PTBD) technique. with the subsequent development of many new devices, PTCS is now recognized to be an indispensable diagnostic and
therapeutic
procedure for the management of diseases of the biliary tract. Considering the operative complications, percutaneous intervention is an attractive alternative to surgery in selected patients. We observed the usefulness of PTCS in various disease
of
biliary tract.
@ES Methods:
@EN From June 1992 to January 1995, we experienced 65 cases of patients managed by PTCS. PTCS was done via dilated PTBD tract with flexible cholangioscope. 53 cases were benign biliary diseases and 12 cases were malignant diseases.
@ES Results:
@EN Indications of PTCS in benign biliary diseases were intrahepatic duct stones 942 cases), common bile duct stones (5 cases), benign stricture without stone (4 cases) and biliary stent occlusion (2 cases). In the cases of intrahepatic duct
stones,
complete removal of stones was achieved in 29 of 42 cases (76.2%). In the cases of choledocholithiasis, complete removal of stones was achieved in 5 of 5 patients (100%). PTCS for benign biliary strictures with or without stones were 18 cases, 16
cases
were managed by balloon dilatation and/or catheter placement and 2 cases were corrected surgically. PTCS for malignant biliary diseases were 12 cases. It was possible to differentiate benign bile duct stenosis from bile duct carcinoma by PTCS and
biopsy. Two cases of bleeding during tract dilatation and PTCS and one case of sinus tract rupture were developed, but successfully managed by conservative treatment.
@ES Conclusions:
@EN Percutaneous Transhepatic Cholangioscopy (PTCS) is a safe and effective procedure for diagnosis and management of various types of biliary tract diseases. (Korean J Gastroenterol 1995; 27: 463-470)
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