Intraductal ultrasonography for the assessment of preoperative biliary and pancreatic strictures.
Diseases of the biliary and pancreatic ducts are often difficult to diagnose. Although transcutaneous ultrasonography, computer tomography and magnetic resonance greatly improved in performance, two major problems have not been completely solved yet: first, the differentiation of malignant and benign bile duct strictures, and, second, the assessment of the resectability of carcinomas underlying biliary strictures. Ultrasound probes can be inserted through the working channel of the duodenoscope and passed selectively both into the biliary and pancreatic ducts. Ultrasound frequencies of 20 or 30 MHz enable a penetration of up to 2 cm and a resolution of 0.07 to 0.18 mm. The main clinical indication for intraductal ultrasonography of the biliary tract is obstructive jaundice, which requires assessment of bile duct strictures and local tumor staging. Miniprobes can contribute to the differential diagnosis of strictures localized in the main pancreatic duct, and also to localizing small endocrine tumors. Small tumors of the papilla of Vater can be staged before a possible endoscopic resection. Feasibility of the method is excellent in expert hands with almost no added morbidity.
3rd Medical Clinic, University of Medicine and Pharmacy, Croitorilor Street no.19-21, Cluj-Napoca, Romania. matantau@gmail.com
Marcel
M
Tantau
Teodora
T
Pop
Radu
R
Badea
Zeno
Z
Spirchez
Ofelia
O
Moşteanu
Alina
A
Tantau
D002779:Cholestasis / Q000000981:diagnostic imaging*; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D019160:Endosonography / Q000379:methods*; D006801:Humans; D010182:Pancreatic Diseases / Q000000981:diagnostic imaging*; D010183:Pancreatic Ducts / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results