Original Article
Comparison of intraductal ultrasonography characteristics between cholangiocarcinoma and benign bile duct stricture
Qingwei Jiang, Xi Wu, Fang Yao, Dongsheng Wu, Zhilan Meng, Aiming Yang
Published 2019-04-20
Cite as Chin J Dig Endosc, 2019, 36(4): 265-268. DOI: 10.3760/cma.j.issn.1007-5232.2019.04.009
Abstract
ObjectiveTo conclude the intraductal ultrasonography (IDUS) characteristics of cholangiocarcinoma and improve endoscopic diagnosis for cholangiocarcinoma by comparing manifestations of IDUS between cholangiocarcinoma and benign bile duct stricture.
MethodsA total of 52 patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and IDUS with definite diagnosis of cholangiocarcinoma from January 2012 to January 2017 were included in this retrospective study, and 59 patients undergoing ERCP and IDUS during the same period with definite diagnosis of benign bile duct stricture were included as control. Clinical data, indices of laboratory tests, and manifestations of IDUS (including length of stricture, echo feature, thickness of bile duct, symmetry, and integrity of outer membrane of bile duct wall) were collected and compared between the two groups.
ResultsThe clinical manifestations and results of laboratory examination showed no significant differences between the two groups. Intraductal brushing cytology and forceps biopsy showed 28.9% and 40.0% malignant evidence respectively. IDUS showed thicker bile duct in the cholangiocarcinoma group (6.8±4.0 mm VS 4.1±2.3 mm, P<0.01). Proportion of hypoechoic and nonsymmetrical thickened bile duct was higher in the cholangiocarcinoma group (78.8% VS 44.1%, 92.3% VS 50.8%, respectively, all P<0.01). Outer membrane of bile duct destruction occurred in 8 cases (15.4%) in the cholangiocarcinoma group, whereas none was seen in the control group.
ConclusionHypoecho and nonsymmetrical thickness on IDUS may be indicators of cholangiocarcinoma, and destruction of bile duct outer membrane is highly suggestive of cholangiocarcinoma.
Key words:
Endosonography; Cholangiopancreatography, endoscopic retrograde; Bile duct neoplasms; Diagnosis
Contributor Information
Qingwei Jiang
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Xi Wu
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Fang Yao
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Dongsheng Wu
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Zhilan Meng
Department of Pathology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
Aiming Yang
Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China