Abstract
EUS was performed in choledochal diseases by a radial scanning ultrasonic endoscope (GF-UM 2/EU-M 2) equipped with 10 MHz transducer. In the first report prior to this study, we clarified the histological structure of the wall of the common bile duct on echograms and referred to the visualization method of the common bile duct in clinical cases. In this study, EUS was performed in 20 cases including 6 cases of choledochal cancer, 6 cases of choledocholithiasis, 2 cases of cholangitis, 3 cases of the stenosis of the common bile duct. In the cases of the choledochal cancer, we could visualize tumor lesions clearly in 3 out of 4 cases in which surgical operation could be done. Concerning the diagnosis of the extra-mural invasion, we could make an exact diagnosis in 2 out of 3 cases by EUS. In cases of the choledocholithiasis, we could make an exact diagnosis in all cases and could point out 10 out of 11 stones which were cofirmed by operation or EST. In cases of the cholangitis, the thickness of the 2nd layer in three layer structure of the choledochal wall was the characteristic finding. In the cases with stenosis of the common bile duct, it was thought to be a very important finding in the differential diagnosis of malignancy or benign whether a tumor lesion was visualized by EUS. In conclusion, we were convinced that EUS might be a very useful technique in the diagnosis of the diseases of the common bile duct.
