| Theme |
Diagnosis of Biliary Tract Cancer -- Present Status and Perspective |
| Title |
Diagnosis of Biliary Cancer Using Percutaneous Transhepatic Cholangioscopy and Cholecystoscopy |
| Author |
Kazumu Okushima |
Department of Internal Medicine, Second Teaching Hospital, Fujita Health University, School of Medicine |
| Author |
Kazuo Inui |
Department of Internal Medicine, Second Teaching Hospital, Fujita Health University, School of Medicine |
| Author |
Junji Yoshino |
Department of Internal Medicine, Second Teaching Hospital, Fujita Health University, School of Medicine |
| Author |
Hironao Miyoshi |
Department of Internal Medicine, Second Teaching Hospital, Fujita Health University, School of Medicine |
| Author |
Yuta Nakamura |
Department of Internal Medicine, Second Teaching Hospital, Fujita Health University, School of Medicine |
| Author |
Hiroshi Ukai |
Department of Internal Medicine, Second Teaching Hospital, Fujita Health University, School of Medicine |
| [ Summary ] |
We described current diagnostic methods, and future prospects for use of PTCS and PTCCS for biliary cancer treatment. A16F catheter was used to dilate a fistula that has been created for PTBD (or PTCCD). Through this fistula an endoscope was introduced into the bile duct (or the gallbladder) to perform PTCS (or PTCCS). The major findings concerning biliary cancer by PTCS were: bile duct stenosis or obstructions with irregularly shaped erythematous areas: papillary or nodular tubercula; proliferation of dilated and tortuous vessels supplying the tumor; and mucosa with an irregular granular appearance. Ninty seven percent of cancers were positively identified through biopsy. It was found that PTCS was effective in determining tumor extension and superfacial spreading. It was concluded that PTCS is the most effective method for determining the hepatic spread of an extrahepatic bile duct cancer. The major findings in early gallbladder cancer with PTCCS were: papillary or nodular tubercula with proliferation of dilated and tortuous vessels, erosion, and bleeding; and mucosa with an irregular granular appearance. The positivity rate for cancer with PTCS biopsies was 97%. PTCCS enables one to make a definitive diagnosis of early gallbladder cancer. However, with the development of endoscopic ultrasonography permiting diagnosis of early gallbladder cancer, only a few cases will require PTCCS for diagnoses. |