title: [Intraductal ultrasonography for the selection of self expandable metal stent in extrahepatic bile duct carcinoma].
abstract: OBJECTIVE
  Endoscopic stent insertion with self expandable metal stent (SEMS) is one of the standard palliative treatments for the patients with unresectable bile duct carcinoma. The aim of this study was to determine whether detection of longitudinal spread of extrahepatic bile duct carcinoma by intraductal US (IDUS) would be helpful in the selection of metal stent for the palliative drainage in bile duct carcinoma.
  
  
  METHODS
  Seventeen patients with histologically proven unresectable extrahepatic bile duct carcinoma who underwent endoscopic retrograde cholangiography with IDUS were included. Longitudinal cancer extension along the bile duct was determined and, then, compared with the cholangiographic image. The type and length of SEMS was selected based on IDUS findings.
  
  
  RESULTS
  IDUS demonstrated more extensive tumor spread than ERC in 7 of 17 (41.2%) patients with the hepatic side of strictures and in 7 of 16 (43.8%) patients with the duodenal side of strictures. Five of 17 (29.4%) patients have changed the plan of endoscopic biliary drainage with SEMS after IDUS. There was no early dysfunction associated with endoscopic biliary drainage.
  
  
  CONCLUSIONS
  IDUS prior to biliary drainage would be useful in demonstrating longitudinal extension of extrahepatic bile duct carcinoma. It has a potential role in helping stent selection and identifying factors which predict early stent dysfunction.
authors.affiliation: Digestive Disease Center, Institute for Digestive Research, Department of Internal Medicine, Soon Chun Hyang University School of Medicine, Yongsan-Gu, Seoul, Korea.
authors.forename: Hyung Geun
authors.initials: HG
authors.lastname: Yoon
authors.forename: Jee Heon
authors.initials: JH
authors.lastname: Kang
authors.forename: Eun Jeung
authors.initials: EJ
authors.lastname: Lee
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Sang Gyun
authors.initials: SG
authors.lastname: Kim
authors.forename: Young Koog
authors.initials: YK
authors.lastname: Gheon
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Young Deok
authors.initials: YD
authors.lastname: Cho
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Lee
authors.forename: Moon Sung
authors.initials: MS
authors.lastname: Lee
authors.forename: Seong Jin
authors.initials: SJ
authors.lastname: Park
authors.forename: Hae Kyung
authors.initials: HK
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: D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D017734:Bile Ducts, Extrahepatic / Q000000981:diagnostic imaging* / Q000601:surgery*; D002277:Carcinoma / Q000000981:diagnostic imaging / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D015607:Stents; D014463:Ultrasonography