Imaging of common bile duct by linear endoscopic ultrasound

Figure 5 Following down from upper 1/3. A: A dilated bile duct can be easily followed down and push of the scope in a forward direction along with slight rotation changes the window of imaging from the liver window to pancreatic window. The parenchyma of head of pancreas provides an excellent window for visualization of dilated CBD. With experience even a non-dilated duct can be easily visualized from this position; B: When the probe comes to lie in fundus of stomach the stack of hepatic artery, portal vein and common bile duct can be seen through the liver window. In this picture the hepatic artery lies closest to the transducer, the portal vein lies on the undersurface of liver and the CBD is seen beyond the portal vein. The portal vein and the bile duct can be followed down towards the pancreas from the liver. The portal vein is followed down as SMV; C: When the probe comes to lie anterior to head of pancreas the stack of gastroduodenal artery, portal vein and bile duct can be seen with the help of the pancreatic window. CBD: Common bile duct; SV: Splenic vein; PV: Portal vein; HA: Hepatic artery; MPD: Main pancreatic duct; SMV: Superior mesenteric vein.