Skip to main content
SpringerLink
Log in

Intraductal Ultrasonography

  • Chapter
  • First Online:
Biliopancreatic Endoscopy

  • 777 Accesses

Abstract

There are several hollow or solid organs, visceral vessels, and even lymph nodes surrounding the biliary tree and pancreas; therefore, it is relatively complex for the clinicians to clearly visualize biliopancreatic anatomy. Ultrasonography (US) is usually the first diagnostic tool used for the evaluation of the possible biliopancreatic lesions. However, the diagnostic yield of US is limited by the poor penetration of the ultrasound beam due to interference from interposed intestinal gas or fatty tissues of the abdominal wall. It has been reported that the accuracy of US in demonstrating the cause of biliary tract obstruction is about 2/3 and the periampullary region is the most difficult area for US to clearly depict due to the interference of bowel gas [1]. Computed tomography (CT), widely used for the evaluation of biliopancreatic diseases, has the advantages of noninvasiveness, operator independence, and high technical achievement rate. However, CT carries the risks of radiation exposure and contrast-induced kidney injury or allergic reaction. Magnetic resonance imaging (MRI) has remained as a low-risk diagnostic technique with good performance for the assessment of biliopancreatic disorders. MRI is a time-consuming procedure; furthermore, the delineating ability will be diminished in subjects without sufficient fat planes or a biliary tree containing little fluid. Moreover, MRI is contraindicated in patients with claustrophobia or implantation of electronic devices. Endoscopic retrograde cholangiopancreatography (ERCP) remains mainly as a therapeutic modality for biliopancreatic disorders, but it carries the risks of pancreatitis, cholangitis, hemorrhage, perforation, and even mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Songur Y, Temucin G, Sahin B. Endoscopic ultrasonography in the evaluation of dilated common bile duct. J Clin Gastroenterol. 2001;33:302–5.

    Article  CAS  PubMed  Google Scholar 

  2. Yasuda K, Mukai H, Nakajima M, et al. Clinical application of ultrasonic probes in the biliary and pancreatic duct. Endoscopy. 1992;24(S 1):370–5.

    Article  PubMed  Google Scholar 

  3. Kimmey MB, Martin RW, Silverstein FE. Endoscopic ultrasound probes. Gastrointest Endosc. 1990;36(Suppl 2):S40–6.

    Article  CAS  PubMed  Google Scholar 

  4. Kanemaki N, Nakazawa S, Inui K, et al. Three-dimensional intraductal ultrasonography: preliminary results of a new technique for the diagnosis of diseases of the pancreatobiliary system. Endoscopy. 1997;29(8):726–31.

    Article  CAS  PubMed  Google Scholar 

  5. Tringali A, Lemmers A, Meves V, et al. Intraductal biliopancreatic imaging: European Society of Gastrointestinal Endoscopy (ESGE) technology review. Endoscopy. 2015;47:739–53.

    Article  PubMed  Google Scholar 

  6. Fujita N, Noda Y, Kobayashi G, et al. Intraductal ultrasonography (IDUS) for the diagnosis of biliopancreatic diseases. Best Pract Res Clin Gastroenterol. 2009;23:729–42.

    Article  PubMed  Google Scholar 

  7. Menzel J, Domschke W. Intraductal ultrasonography (IDUS) of the pancreato-biliary duct system: personal experience and review of the literature. Eur J Ultrasound. 1999;10:105–15.

    Article  CAS  PubMed  Google Scholar 

  8. Furukawa T, Tsukamoto Y, Naitoh Y, et al. Evaluation of intraductal ultrasonography in the diagnosis of pancreatic cancer. Endoscopy. 1993;25:577–81.

    Article  CAS  PubMed  Google Scholar 

  9. Lim SU, Park CH, Kee WJ, et al. Intraductal ultrasonography without radiocontrast cholangiogram in patients with extrahepatic biliary disease. Gut Liver. 2015;9:540–6.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Fujita N, Noda Y, Kobayashi G. Analysis of the layer structure of the gallbladder wall delineated by endoscopic ultrasound using the pinning method. Dig Endosc. 1995;7:353–6.

    Article  Google Scholar 

  11. Noda Y, Fujita N, Kobayashi G, et al. Comparison of echograms by a microscanner and histological findings of the common bile duct, in vitro study. Jpn J Gastroenterol. 1997;94:172–9.

    CAS  Google Scholar 

  12. Kundu R, Pleskow D. Clinical application of Intraductal ultrasound during endoscopic retrograde cholangiopancreatography. Gastrointest Endosc Clin N Am. 2009;19:615–28.

    Article  PubMed  Google Scholar 

  13. Kim HN, Park CH, Cho EA, et al. Role of balloon-sheathed intraductal ultrasonography for patients with extensive pneumobilia. Gut Liver. 2015;9:561–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Varadarajulu S. A modified technique to overcome the limitations of intraductal ultra-sound for diagnosis of common bile duct stones. Endoscopy. 2008;40(S02):E152.

    Article  PubMed  Google Scholar 

  15. Moon JH, Cho YD, Cha S-W, et al. The detection of bile duct stones in suspected biliary pancreatitis: comparison of MRCP, ERCP, and intraductal US. Am J Gastroenterol. 2005;100:1051–7.

    Article  PubMed  Google Scholar 

  16. Endo T, Ito K, Fujita N, et al. Intraductal ultrasonography in the diagnosis of bile duct stones: when and whom? Dig Endosc. 2011;23:173–5.

    Article  PubMed  Google Scholar 

  17. Kim BJ, Kang P, Lee JK, et al. Are the echogenicities on intraductal ultrasonography really biliary microlithiasis? Dig Dis Sci. 2010;55:836–41.

    Article  PubMed  Google Scholar 

  18. Das A, Isenberg G, Wong RC, et al. Wire-guided intraductal US: an adjunct to ERCP in the management of bile duct stones. Gastrointest Endosc. 2001;54:31–6.

    Article  CAS  PubMed  Google Scholar 

  19. Tamada K, Ohashi A, Tomiyama T, et al. Comparison of intraductal ultrasonography with percutaneous transhepatic cholangioscopy for the identification of residual bile duct stones during lithotripsy. J Gastroenterol Hepatol. 2001;16:100–3.

    Article  CAS  PubMed  Google Scholar 

  20. Catanzaro A, Pfau P, Isenberg GA, et al. Clinical utility of intraductal US for evaluation of choledocholithiasis. Gastrointest Endosc. 2003;57:648–52.

    Article  PubMed  Google Scholar 

  21. Tsuchiya S, Tsuyuguchi T, Sakai Y, et al. Clinical utility of intraductal US to decrease early recurrence rate of common bile duct stones after endoscopic papillotomy. J Gastroenterol Hepatol. 2008;23:1590–5.

    Article  PubMed  Google Scholar 

  22. Kim HS, Moon JH, Choi HJ, et al. The role of intraductal US in the management of idiopathic recurrent pancreatitis without a definite cause on ERCP. Gastrointest Endosc. 2011;73:1148–54.

    Article  PubMed  Google Scholar 

  23. Tamada K, Tomiyama T, Wada S, et al. Endoscopic transpapillary bile duct biopsy with the combination of intraductal ultrasonography in the diagnosis of biliary strictures. Gut. 2002;50:326–31.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Tamada K, Kanai N, Wada S, Tomiyama T, Ohashi A, Satoh Y, et al. Utility and limitations of intraductal ultrasonography in distinguishing longitudinal cancer extension along the bile duct from inflammatory wall thickening. Abdom Imaging. 2001;26:623–31.

    Article  CAS  PubMed  Google Scholar 

  25. Menzel J, Poremba C, Dietl KH, et al. Preoperative diagnosis of bile duct strictures—comparison of intraductal ultrasonography with conventional endosonography. Scand J Gastroenterol. 2000;35:77–82.

    Article  CAS  PubMed  Google Scholar 

  26. Heinzow HS, Kammerer S, Rammes C, et al. Comparative analysis of ERCP, IDUS, EUS and CT in predicting malignant bile duct strictures. World J Gastroenterol. 2014;20:10495–503.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Tamada K, Ido K, Ueno N, et al. Assessment of hepatic artery invasion by bile duct cancer using intraductal ultrasonography. Endoscopy. 1995;27:579–83.

    Article  CAS  PubMed  Google Scholar 

  28. Inui K, Miyoshi H, Yoshino J. Bile duct cancers: what can EUS offer? Intraductal US, 3D-IDUS? FNA – is it possible? Endoscopy. 2006;38:47–9.

    Article  Google Scholar 

  29. Tamada K, Ido K, Ueno N, et al. Preoperative staging of extrahepatic bile duct cancer with intraductal ultrasonography. Am J Gastroenterol. 1995;90:239–46.

    CAS  PubMed  Google Scholar 

  30. Tamada K, Nagai H, Yasuda Y, et al. Transpapillary intraductal US prior to biliary drainage in the assessment of longitudinal spread of extrahepatic bile duct carcinoma. Gastrointest Endosc. 2001;53:300–7.

    Article  CAS  PubMed  Google Scholar 

  31. Moon JH. The usefulness of IDUS-guided transpapillary bile duct biopsy for the diagnosis of malignant biliary strictures. Endoscopy. 2011;43(S03):A53.

    Google Scholar 

  32. Tanaka M, Fernandez-del Castillo C, Adsay V, et al. International consensus guidelines 2012 for the management of IPMN and MCN of the pancreas. Pancreatology. 2012;12:183–97.

    Article  PubMed  Google Scholar 

  33. Paini M, Crippa S, Scopelliti F, et al. Extent of surgery and implications of transection margin status after resection of IPMNs. Gastroenterol Res Pract. 2014;2014:1–10.

    Article  Google Scholar 

  34. Cheon YK, Cho YD, Jeon SR, et al. Pancreatic resection guided by preoperative intraductal ultrasonography for intraductal papillary mucinous neoplasm. Am J Gastroenterol. 2010;105:1963–9.

    Article  PubMed  Google Scholar 

  35. Menzel J, Domschke W. Intraductal ultrasonography may localize islet cell tumours negative on endoscopic ultrasound. Scand J Gastroenterol. 1998;33:109–12.

    Article  CAS  PubMed  Google Scholar 

  36. Heinzow HS, Lenz P, Lallier S, et al. Ampulla of Vater tumors: impact of intraductal ultrasound and transpapillary endoscopic biopsies on diagnostic accuracy and therapy. Acta Gastroenterol Belg. 2011;74:509–15.

    PubMed  Google Scholar 

  37. Ito K, Fujita N, Noda Y, et al. Preoperative evaluation of ampullary neoplasm with EUS and transpapillary intraductal US: a prospective and histopathologically controlled study. Gastrointest Endosc. 2007;66:740–7.

    Article  PubMed  Google Scholar 

  38. Suárez V, Puerta A, Santos LF, et al. Portal hypertensive biliopathy: a single center experience and literature review. World J Hepatol. 2013;5:137–44.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Nakazawa T, Naitoh I, Hayashi K, et al. Diagnosis of IgG4-related sclerosing cholangitis. World J Gastroenterol. 2013;19:7661–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Meister T, Heinzow H, Heinecke A, et al. Post-ERCP pancreatitis in 2364 ERCP procedures: is intraductal ultrasonography another risk factor? Endoscopy. 2011;43:331–6.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Digestive Disease Center, Show-Chwan Memorial Hospital, Changhua, Taiwan

    Chien-Hua Chen

Authors
  1. Chien-Hua Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chien-Hua Chen .

Editor information

Editors and Affiliations

  1. Division of Gastroenterology and Hepatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan

    Kwok-Hung Lai

  2. Show-Chwan Health Care System, Chang-Hua, Taiwan

    Lein-Ray Mo

  3. Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan

    Hsiu-Po Wang

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chen, CH. (2018). Intraductal Ultrasonography. In: Lai, KH., Mo, LR., Wang, HP. (eds) Biliopancreatic Endoscopy. Springer, Singapore. https://doi.org/10.1007/978-981-10-4367-3_15

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-4367-3_15

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-4366-6

  • Online ISBN: 978-981-10-4367-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation