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Two cases of immunoglobulin (IgG4)-related biliary and pancreaticobiliary disease are reported to define its diagnostic features. Case 1 presented with obstructive jaundice and showed IgG4-related disease (RD) involving right and left hepatic duct, common bile duct and gallbladder. Case 2 presented as periampullary mass. Both patients underwent surgical intervention. However, certain clinical and radiological features were present in these cases indicative of the possibility of IgG4-RD.
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Objective To investigate the value of therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in the patients with pancreaticobiliary diseases and the methods to manage complications. Methods 100 cases treated with ERCP were analyzed retrospectively. Compared with hepatobiliary diseases were examined with ERCP,abdominal B-ultrasound and CT simultaneously. Results 100 cases underwent ERCP,the success and failure were 95 cases and 5 cases respectively;64 cases with simple diagnostic in ERCP,36 cases in EST;EST was performed on 36 patients with hepatobiliary stones. Stones were removed from 14 patients with single common bile duct stones and 19 patients with multiple duct stones;The diagnostic rate of ERCP、abdominal B ultrasound、CT were 96.0%、39. 0% and 64.0% respectively. The rate of diagnosis in ERCP were higher than the B ultrasound and CT(x2 =7. 05 ,P ＜ 0. 01 ,x2 = 3.83, P ＜ 0. 05); The complication of gastro-intestinal tract bleeds in 2 cases (2.0%)、 acute cholangitis in 1 case (1.0%) 、acute pancreatitis in 2 cases(2.0)%, pass through the internal medicine to treat conservatively completely recovers from an illness after treatment. Conclusion Therapeutic ERCP was effective and minimally invasive treatment for pancreaticobiliary diseases.
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Objective To determine how endoscopic retrograde cholangiopancreatography (ERCP) compared with magnetic resonance cholangiopancreatography (MRCP) in the diagnosis of pancreaticobiliary diseases. Methods A total of 40 patients with suspected pancreaticobiliary diseases underwent both MRCP and ERCP. Images obtained from ERCP and MRCP were compared. Results Pictures of both the examinations in the 40 patients had come out satisfactorily revealing the pancreatic duct and the biliary tree. The sensitivity, specificity and accuracy were 87% (34/39), 100% (1/1) and 88% (35/40) in MRCP and 100% (39/39), 100% (1/1) and 100% (40/40) in ERCP, respectively, without significant differences between the two examinations. Conclusions Although MRCP offers a diagnostic means equivalent to ERCP, it cannot take the place of the latter as regards identification of biliary obstruction.
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Objective To discuss the clinical applied value of MSCT MPR in displaying the relation between periampullary diverticula(PAD) and pancreaticobiliary duct.Methods There were 32 patients with PAD found through the volume scans by MSCT, and proved by endosope or GI. The axial source images after being reconstructed were transmitted to Vitrea workstation for observation, and the images which were valid to show the relation between PAD and pancreaticobiliary duct were get.Results In 32 patient,34 PADs were found,22PADs located above the papilla , 7 located in the neck edge of diverticula , 4 were papilla in diverticula and 1 located below papilla .Conclusion MPR can clearly display PAD and pancreaticobiliary duct, their relation and pancreaticobiliary disease.