Abstract
Findings of endoscopic retrograde cholangiopancreatography (ERCP) in 12 patients with relatively early stage of primary biliary cirrhosis (PBC) were evaluated. Endoscopic retrograde pancreatogram (ERP) were normal in all patients . Cholelithiasis was found in only one patient. In six cases in which intrahepatic bile ducts were opacif ied up to the forth branches (the first branch means right and left hepatic bile ducts), endoscopic retrograde cholangiogram (ERC) showed no characteristic findings as PBC in all cases. In the other six cases in which intrahepatic bile ducts were sufficiently opacified up to more distal branches than those of the fifth, periductal oozing of urografin from the intrahepatic bile ducts were observed in all cases, and dotted line appearance of the intrahepatic bile ducts were seen in three cases. Histologic examination of liver biopsy specimen in these 12 patients revealed diffuse destruction of interlobular bile ducts (40-80μ in diameter) including typical chronic non-suppurative destructive cholangitis (CNSDC), and the bigger bile ducts (200μ250μ in diameter) were also injured . Periductal oozing of contrast medium around the intrahepatic bile ducts might occur from such destructed portion of relatively bigger branches of intrahepatic bile ducts . A dotted line appearance of intrahepatic bile ducts seemed to suggest opacification of segmentally injured intrahepatic bile ducts . These two abnormal ERC findings were not observed in the 32 patients of control group whose intrahepatic bile ducts were opacif ied up to more distal branches than those of the fifth.
