A prospective study of 33 patients with cholestatic jaundice was performed with combined use of endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangiography (PTC), ultrasonography, and liver biopsy. A higher rate of success with PTC in 25 cases of extrahepatic cholestasis was offset by the better score of ERCP in 8 cases of intrahepatic cholestasis and its wider diagnostic scope. The procedures were complementary in 10 cases. Ultrasonic imaging of intrahepatic bile ducts proved useful for selecting the first cholangiographic technique. Liver biopsy established etiology in intrahepatic cholestasis. Our combined approach allowed us to develop through objective criteria a diagnostic flow chart of cholestasis.
Relata-se a experiência das primeiras 150 duodenoscopias consecutivas para colan giopancreatografia retrógrada endoscópica (CPRE). Descreve-se o material e meto dologia utilizados, incluindo a pesquisa sistemática do follow-;ip dos doentes exa minados. A duodenoscopia foi diagnóstica em 19 casos. A canulação da papua de Vater, com visualização das vias biliares e/ou pancreáticas foi conseguida em 106 de 131 tentativas (81 % de êxitos técnicos): CPRE em 55, CRE em 22 e PRE em 29 Esta percentagem elevou-se para 88 % nos últimos 50 exames. Predominaram as indi cações clínicas por suspeita de patologia biliar (colestase em 72. colangite recorrente em 22 e síndrome dolorosa pós-colecistectomia em 9). No grupo da colestase, o diag Recebido para publicação.-19 Dezembro 1978
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.