PERCUTANEOUS TRANSHEPATIC CHOLANGIOSCOPY FOR MALIGNANT BILIARY TRACT DISEASES-PTCS OR PTCCS-

Abstract

With an advancement of technique of percutaneous transhepatic biliary drainage (PTCD) and dilatation of PTCD fistula, percutaneous transhepatic cholecystoscopy (PTCCS) or cholangioscopy (PTCS) by way of the fistula has been clinically performed in several institutions. Moreover, it has been recognized that PTCCS and PTCS are established as a safe method with an improvement of choledochof iberscope. PTCS and PTCCS have been carried out in 5 cases with cholangioma and 3 cases with gallbladder carcinoma respectively for the last one year. These endoscopic techniques allow biopsy to obtain a correct diagnosis under direct visual control and made the laser beam applicable for crushing the stones or for treatment of non-resectable tumor. Furthermore, they are very useful for the insertion of the tube for endoprosthesis into the biliary tract across the site of tumor to obtain a good biliary drainage. In this paper, the methodology, the indication, problems and limitations of PTCD and PTCCS are discussed based on the experiences with these techniques.