title: Utility of Intraductal Ultrasonography as a Diagnostic Tool in Patients with Early Distal Cholangiocarcinoma.
abstract: OBJECTIVE
  It is difficult to diagnose cholangiocarcinoma in the early stages because most patients present with jaundice, which is generally thought to be the most important symptom at diagnosis. Despite improvements to surgical instruments and techniques, these rates are not quite satisfactory. Intraductal ultrasound (IDUS) is easy to handle due to the wire-guided, thin-caliber, and high-frequency probe. The purpose of the present study was to assess the efficacy of IDUS as a diagnostic tool for patients with early distal cholangiocarcinoma.
  
  
  METHODS
  We enrolled 23 with early distal cholangiocarcinoma. The cholangiography and IDUS findings were retrospectively analyzed. The morphology of the tumors detected by IDUS was also classified including localized wall thickening, polypoid lesion, and sessile tumor.
  
  
  RESULTS
  The morphologies on IDUS were as follows: five (21.7%) localized wall thickenings, five (21.7%) polypoid lesions, and 13 (56.5%) sessile tumors.
  
  
  CONCLUSIONS
  Since forceps biopsy complemented by IDUS can substantially improve the diagnostic rate, pathological investigations should be performed simultaneously after detection by IDUS. We believe that noninvasive modalities should be followed by IDUS and used as a decisive approach to distinguish between benign and malignant status.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Shintaro
authors.initials: S
authors.lastname: Shibutani
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Egawa
authors.forename: Shinobu
authors.initials: S
authors.lastname: Hayashi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nagashima
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D018281:Cholangiocarcinoma / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D042883:Choledocholithiasis / Q000150:complications; D015331:Cohort Studies; D055088:Early Detection of Cancer; D019160:Endosonography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies