Suprapancreatic biliary obstruction: CT evaluation.
In a 5-year period, 92 patients with biliary obstruction proximal to the pancreatic segment were evaluated with computed tomography (CT). Seventy-three were judged to have technically optimal studies. Observations of the level of obstruction were compared with data from 50 percutaneous transhepatic cholangiograms; CT data enabled the level of obstruction to be correctly predicted in 46. CT enabled correct prediction of the distribution of obstructing lesions in all 18 patients with intrahepatic obstruction. Forty-four of the 73 patients had pathologic examination of the porta hepatitis. CT findings of obstructing mass and lesser omental nodes resulted in correct prediction of malignancy in 25 (92%) of 27 patients; the absence of such findings enabled correct prediction of benign disease in 13 (77%) of 17 individuals. CT is most valuable as a noninvasive means of planning surgical or radiologic drainage procedures in patients with biliary obstruction.
D001649:Bile Duct Diseases / Q000150:complications; D001650:Bile Duct Neoplasms / Q000150:complications; D002758:Cholangiography; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D014057:Tomography, X-Ray Computed