DIRECT CHOLANGIOSCOPY USING A DOUBLE‐BALLOON ENTEROSCOPE: CHOLEDOCHOJEJUNOSTOMY WITH INTRADUCTAL BILIARY CARCINOMA |
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Authors: | Yoshinobu Okabe Kotaro Kuwaki Hiroshi Kawano Ryohei Kaji Gen Sugiyama Yusuke Ishida Makiko Yasumoto Yoshiki Naito Atsushi Toyonaga Osamu Tsuruta Michio Sata |
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Affiliation: | 1. Division of Gastroenterology, Department of Medicine,;2. Department of Pathology, Kurume University School of Medicine, Kurume and;3. Yasumoto Hospital, Kurume, Japan |
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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. |
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Keywords: | choledochojejunostomy direct cholangioscopy double‐balloon enteroscope intraductal biliary carcinoma |
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