title: Direct cholangioscopy using a double-balloon enteroscope: choledochojejunostomy with intraductal biliary carcinoma.
abstract: A 75-year-old man who underwent choledochojejunostomy for gallstones 30 years ago was hospitalized for general malaise. Abdominal computed tomography revealed marked dilation of the intrahepatic bile duct in the right lobe and an image of a hypervascular tumor. Endoscopic retrograde cholangiography using double-balloon enteroscopy (DBE) showed a filling defect that was localized to the right hepatic bile duct. Furthermore, the scope was able to readily pass through the anastomosed site of the choledochojejunostomy and, therefore, we observed the interior of the bile duct using the same scope. We obtained an image showing a whitish, papillary-like tumor, and a biopsy of the tumor rendered the pathology of intraductal papillary mucinous carcinoma. Direct cholangioscopy using DBE is a useful diagnostic tool, particularly in patients with a past history of choledochojejunostomy.
authors.affiliation: Department of Medicine, Kurume University School of Medicine, Kurume, Japan. yib01074@nifty.com
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Okabe
authors.forename: Kotaro
authors.initials: K
authors.lastname: Kuwaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kawano
authors.forename: Ryohei
authors.initials: R
authors.lastname: Kaji
authors.forename: Gen
authors.initials: G
authors.lastname: Sugiyama
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ishida
authors.forename: Makiko
authors.initials: M
authors.lastname: Yasumoto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Naito
authors.forename: Atsushi
authors.initials: A
authors.lastname: Toyonaga
authors.forename: Osamu
authors.initials: O
authors.lastname: Tsuruta
authors.forename: Michio
authors.initials: M
authors.lastname: Sata
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis*; D000368:Aged; D001650:Bile Duct Neoplasms / Q000175:diagnosis*; D001653:Bile Ducts, Intrahepatic; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy; D002291:Carcinoma, Papillary / Q000175:diagnosis*; D002404:Catheterization; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002768:Choledochostomy; D003287:Contrast Media; D042882:Gallstones / Q000601:surgery; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed
chemical_list: D014408:Biomarkers, Tumor; D003287:Contrast Media