The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Adenocarcinoma in situ of the Distal Common Bile Duct Diagnosed by Percutaneous Transhepatic Cholangioscopy

  • Yang, Hyo-Joon (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kim, Jai-Hwan (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Chun, Jae-Young (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kim, Su-Jin (Department of Radioglogy, Seoul National University Bundang Hospital) ;
  • Lee, Sang-Hyub (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Kim, Haer-Young (Department of Pathology, Seoul National University Bundang Hospital) ;
  • Hwang, Jin-Hyeok (Department of Internal Medicine, Seoul National University College of Medicine)
  • Published : 2012.06.01
⟨ Previous Next ⟩

Abstract

Extrahepatic cholangiocarcinoma is often clinically challenging to diagnose. Even multidisciplinary approaches which include computed tomography, magnetic resonance imaging, and endoscopic retrograde cholangiography are unsatisfactory in some cases, especially with biliary stricture. Percutaneous transhepatic cholangioscopy (PTCS) with its direct visualization for biopsy appears to be a promising technique for detecting cholangiocarcinoma at an early stage. We report a case of adenocarcinoma in situ of the distal common bile duct (CBD) that was confirmed by PTCS. This case suggests the useful role of PTCS in the differential diagnosis of a distal CBD obstruction, particularly when other diagnostic modalities do not provide definitive information.

Keywords

References

  1. Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liver Dis 2004;24:115-125. https://doi.org/10.1055/s-2004-828889
  2. de Groen PC, Gores GJ, LaRusso NF, Gunderson LL, Nagorney DM. Biliary tract cancers. N Engl J Med 1999;341:1368-1378. https://doi.org/10.1056/NEJM199910283411807
  3. Anderson CD, Pinson CW, Berlin J, Chari RS. Diagnosis and treatment of cholangiocarcinoma. Oncologist 2004;9:43-57.
  4. Curado MP, Edwards B, Shin HR, et al. Cancer incidence in five continents, Vol. IX. IARC Scientific Publications No. 160. Lyon: IARC, 2007.
  5. DeOliveira ML, Cunningham SC, Cameron JL, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg 2007;245:755-762. https://doi.org/10.1097/01.sla.0000251366.62632.d3
  6. Joo YH, Myung SJ, Kim MH, et al. Clinical study on 193 cases of extrahepatic bile duct carcinomaand its prognostic factors. Korean J Gastroenterol 1999;33:114-123.
  7. Abu-Hamda EM, Baron TH. Endoscopic management of cholangiocarcinoma. Semin Liver Dis 2004;24:165-175. https://doi.org/10.1055/s-2004-828893
  8. Ponchon T, Genin G, Mitchell R, et al. Methods, indications, and results of percutaneous choledochoscopy: a series of 161 procedures. Ann Surg 1996;223:26-36. https://doi.org/10.1097/00000658-199601000-00005
  9. Simon T, Fink AS, Zuckerman AM. Experience with percutaneous transhepatic cholangioscopy (PTCS) in the management of biliary tract disease. Surg Endosc 1999;13:1199-1202. https://doi.org/10.1007/PL00009620
  10. Nimura Y. Staging of biliary carcinoma: cholangiography and cholangioscopy. Endoscopy 1993;25:76-80. https://doi.org/10.1055/s-2007-1009128