Intraductal ultrasonography for evaluating the patency of biliary metallic stents: correlation with cholangioscopic findings

AbstractBackground: This is the first study to correlate intraductal ultrasonography (IDUS) with cholangioscopy in evaluating the patency of biliary metallic stents. Methods: The findings of IDUS (probe 2.0 mm in diameter and 20-MHz frequency) through a percutaneous transhepatic (n = 24) or transpapillary (n = 2) approach were retrospectively reviewed without other information. Criteria for IDUS are as follows: type 1, the inside of the stent is free; type 2, the inner edge is smooth; type 3, the inner edge is irregular; type 4, the inside of the stent is totally occupied; type 5, the solid echo is connected to the outside mass; type 2+D, a hypoechoic line is seen between the bile duct wall and the inside solid component and the inner edge of the bile duct wall is smooth; type 3+D, an irregular hypoechoic line is seen between the bile duct wall and the inside solid component. Results: In the control group (n = 11), IDUS showed type 1 (n = 9) or type 2 (n = 2). In the occluded group (n = 15), when IDUS showed type 3 or 5, the patients (n= 5) required additional stents (n = 3), microwave coagulation of the tumor (n= 1), or transient external drainage (n= 1). When IDUS showed type 4 (n = 5), after washing, the findings changed to type 2+D (n = 4). When IDUS after washing showed a smooth inner edge (type 2+D), the patients were treated without additional stents more frequently than the other groups (eight of nine vs. two of six), a significant distinction (p < 0.05).Conclusion: IDUS is useful in assessing the patency of metallic stents. When the inside of the stent is totally occupied, however, examination after washing is necessary.

[1]  K. Sugano,et al.  Intraductal US in assessing the effects of radiation therapy and prediction of patency of metallic stents in extrahepatic bile duct carcinoma. , 2000, Gastrointestinal endoscopy.

[2]  M. Sivak,et al.  Prospective evaluation of an over-the-wire catheter US probe. , 2000, Gastrointestinal endoscopy.

[3]  C. Poremba,et al.  Preoperative diagnosis of bile duct strictures--comparison of intraductal ultrasonography with conventional endosonography. , 2000, Scandinavian journal of gastroenterology.

[4]  K. Sugano,et al.  Endoscopic microwave coagulation therapy for bile duct cancer with intraductal ultrasonographic monitoring: brief case report , 2000, American Journal of Gastroenterology.

[5]  K. Sugano,et al.  Preoperative assessment of extrahepatic bile duct carcinoma using three-dimensional intraductal US. , 1999, Gastrointestinal endoscopy.

[6]  K. Sugano,et al.  Prediction of the histologic type of bile duct cancer by using intraductal ultrasonography , 1999, Abdominal Imaging.

[7]  Y. Yasuda,et al.  Preoperative assessment of congenital bile duct dilatation using intraductal US. , 1999, Gastrointestinal endoscopy.

[8]  K. Ido,et al.  Bile duct wall thickness measured by intraductal US in patients who have not undergone previous biliary drainage. , 1999, Gastrointestinal endoscopy.

[9]  T. Yamanaka,et al.  Intraductal ultrasonography in six patients with endoscopic biliary stenting , 1999, Journal of Gastroenterology.

[10]  J. van Dam,et al.  Management of occluded biliary Wallstents , 1998 .

[11]  K. Ido,et al.  Characterization of biliary strictures using intraductal ultrasonography: comparison with percutaneous cholangioscopic biopsy. , 1998, Gastrointestinal endoscopy.

[12]  K. Hausegger,et al.  Treatment of malignant biliary obstruction with polyurethane-covered Wallstents. , 1998, AJR. American journal of roentgenology.

[13]  K. Ido,et al.  Influence of biliary drainage catheter on bile duct wall thickness as measured by intraductal ultrasonography. , 1998, Gastrointestinal endoscopy.

[14]  K. Inui,et al.  Three-dimensional intraductal ultrasonography: preliminary results of a new technique for the diagnosis of diseases of the pancreatobiliary system. , 1997, Endoscopy.

[15]  K. Ido,et al.  Limitations of intraductal ultrasonography in differentiating between bile duct cancer in stage T1 and stage T2: in-vitro and in-vivo studies. , 1997, Endoscopy.

[16]  Y. Hirooka,et al.  Intraductal ultrasonography in diagnosing tumor extension of cancer of the papilla of Vater. , 1997, Gastrointestinal endoscopy.

[17]  K. Ido,et al.  Assessment of the course and variations of the hepatic artery in bile duct cancer by intraductal ultrasonography. , 1996, Gastrointestinal endoscopy.

[18]  K. Ido,et al.  Assessment of Hepatic Artery Invasion by Bile Duct Cancer Using Intraductal Ultrasonography , 1995, Endoscopy.

[19]  K. Ido,et al.  Assessment of Portal Vein Invasion by Bile Duct Cancer Using Intraductal Ultrasonography , 1995, Endoscopy.

[20]  K. Ido,et al.  Preoperative staging of extrahepatic bile duct cancer with intraductal ultrasonography. , 1995, The American journal of gastroenterology.

[21]  C. Zollikofer,et al.  Malignant biliary obstruction: clinical and histopathologic correlation after treatment with self-expanding metal prostheses. , 1994, Radiology.

[22]  P. Brady,et al.  Endoscopic management of expandable metallic biliary stent occlusion. , 1993, Gastrointestinal endoscopy.

[23]  K. Yasuda,et al.  Clinical application of ultrasonic probes in the biliary and pancreatic duct. , 1992, Endoscopy.

[24]  C. Ell,et al.  Broken biliary metal stent after repeated electrocoagulation for tumor ingrowth. , 1992, Gastrointestinal endoscopy.

[25]  E. vanSonnenberg,et al.  Percutaneous intraluminal US in the gallbladder and bile ducts. , 1992, Radiology.

[26]  J. Devière,et al.  Expandable biliary metal stents for malignancies: endoscopic insertion and diathermic cleaning for tumor ingrowth. , 1990, Gastrointestinal endoscopy.