title: Wire-guided intraductal US in the assessment of bile duct strictures with Mirizzi syndrome-like features at ERCP.
abstract: BACKGROUND
  Mirizzi syndrome refers to common hepatic duct obstruction caused by extrinsic compression that is usually from a stone impacted in the cystic duct. The utility of transpapillary intraductal US for assessment of biliary strictures with radiographic features of Mirizzi syndrome was studied retrospectively.
  
  
  METHODS
  Intraductal US was performed in 16 patients with a common hepatic duct stricture caused by extrinsic compression and nonvisualization of the gallbladder by endoscopic retrograde cholangiography. An over-the-wire catheter US probe (20 MHz) was inserted into the bile duct. Intraductal US findings were compared with the final diagnoses at surgery.
  
  
  RESULTS
  Intraductal US was successful in all patients. The extraluminal cause of the common hepatic duct stricture was detected in 14 patients (87.5%). In 9 patients, intraductal US detected an impacted stone outside the common hepatic duct. Intraductal US demonstrated extraluminal lesions without evidence of a stone in 5 patients, including a mass in 4 and asymmetrical, irregular thickening of the bile duct wall in 1 patient. In the remaining 2 patients, intraductal US demonstrated only a distended gallbladder.
  
  
  CONCLUSIONS
  Transpapillary wire-guided intraductal US is useful for assessing biliary strictures with features that suggest Mirizzi syndrome and optimizes management of patients with these findings.
authors.affiliation: Institute for Digestive Research, Digestive Disease Center, Soon Chun Hyang University College of Medicine, Seoul, Korea.
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Young Deok
authors.initials: YD
authors.lastname: Cho
authors.forename: Young Koog
authors.initials: YK
authors.lastname: Cheon
authors.forename: Chang Beom
authors.initials: CB
authors.lastname: Ryu
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Jin Oh
authors.initials: JO
authors.lastname: Kim
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
authors.forename: Yun Soo
authors.initials: YS
authors.lastname: Kim
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Lee
authors.forename: Moon Sung
authors.initials: MS
authors.lastname: Lee
authors.forename: Chan Sup
authors.initials: CS
authors.lastname: Shim
authors.forename: Boo Sung
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000368:Aged; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002769:Cholelithiasis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D001651:Cholestasis, Extrahepatic / Q000000981:diagnostic imaging* / Q000473:pathology; D003251:Constriction, Pathologic; D003549:Cystic Duct / Q000000981:diagnostic imaging / Q000473:pathology; D019160:Endosonography; D005260:Female; D006500:Hepatic Duct, Common / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis; D012189:Retrospective Studies; D013577:Syndrome