Is bile duct stenosis caused by cancer and tumor obstruction? There are new tools for early diagnosis!

"Early detection and early treatment" has always been the golden rule to keep healthy. However, for bile duct stenosis, whether it is caused by benign inflammation or malignant tumor obstruction, the diagnostic effect of abdominal computed tomography, magnetic resonance imaging or retrograde cholangiopancreatography is limited, and patients often have to wait until symptoms such as jaundice and infection appear before making a diagnosis. Fortunately, with the help of choledochoscope, early diagnosis can be made, which is convenient for more accurate treatment in the future.

Dr. Yang (left) said that patients with cholangiocarcinoma diagnosed as early as Mr. Gao are quite rare, and they are often diagnosed when obstructive jaundice occurs. (Photo courtesy/China attached) Endoscopic examination of asymptomatic bile duct stenosis found male cholangiocarcinoma.

/kloc-Mr. Gao, 0/60 years old, is not unwell at ordinary times. He found local stricture of bile duct in a health examination and was told that he needed surgery to completely remove the bile duct and adopt intestinal reconstruction. Faced with such a big operation, Mr. Gao couldn't make a decision for a long time, so he asked Yang, the attending physician of the Department of Gastroenterology, Affiliated Hospital of China Medical University, for a second opinion, and accepted a new type of choledochoscopy at Dr. Yang's suggestion.

After the new choledochoscope entered the patient's bile duct and pancreatic duct, it was found that there was a tumor with the size of 1 cm in the bile duct, and then the section was sent to the pathology department. After 20 minutes of pathological frozen tissue section, it was immediately interpreted as a malignant tumor, so Mr. Gao Made made up his mind to undergo surgical resection and was diagnosed with cholangiocarcinoma after operation. Fortunately, early detection, timely treatment, cancer cells without any lymphatic metastasis, postoperative recovery is good. At present, they only need regular outpatient follow-up.

The accuracy of traditional examination in early diagnosis of biliary tract tumors is low.

Yang, an attending physician in the Department of Gastroenterology, Affiliated Hospital of China Medical University, said that in the face of biliary stricture, it is often a great challenge for doctors to judge whether it is benign inflammation or malignant tumor obstruction. Clinically, retrograde cholangiopancreatography is used to slice the tissues with bile duct stenosis, but the sensitivity is low. In the literature, if the stenosis is caused by malignant tumor, the sensitivity of this section is about 56%; If it is caused by pancreatic cancer, the sensitivity of the slice is lower. Whether cholangiocarcinoma or pancreatic cancer, surgical resection is the main treatment, and chemotherapy or radiotherapy is not effective.

Patients with cholangiocarcinoma diagnosed as early as Mr. Gao are quite rare, and they are often diagnosed when obstructive jaundice occurs. Now, with the help of choledochoscope, more timely diagnosis and accurate treatment can be made, which will benefit more patients.

The new choledochoscope can not only find diseases, but also assist in treatment.

Dr. Yang said that compared with the old choledochoscope, the new choledochoscope has simpler operation and wider range of activities, and its attachment channel can be used for bile duct slicing, laser lithotripsy and other treatments. Choledochoscope can be used not only for the diagnosis of patients with unexplained bile duct stenosis, but also for the treatment of pancreatic duct stenosis or pancreatic duct diseases. Traditional treatment of large bile duct stones or cystic duct stones requires surgical removal. In patients with inoperability or high risk of surgery, choledochoscope can cooperate with laser lithotripsy to avoid surgical treatment, which is a new weapon against biliary diseases!