Percutaneous transhepatic cholangioscopy-assisted biliary polypectomy for local palliative treatment of intraductal papillary neoplasm of the bile duct

Figure 5 Percutaneous transhepatic cholangioscopy-assisted biliary polypectomy for mucin-hypersecreting cast-like type intraductal papillary neoplasm in the intrahepatic bile duct, with technical success in patient five. A: Percutaneous transhepatic cholangioscopy (PTCS) showing the biliary tumors at the proximal end of the stricture; B: Cholangiography showing the location of the stricture in the left intrahepatic bile duct; C: PTCS showed a frond-like tumor; D: The snared tumor (the arrow points to the snare sheath); E: The successfully resected tumor with PTCS-assisted biliary polypectomy (PTCS-BP); F: PTCS showing multiple villous growing tumors; G: PTCS showing some residual tumors (arrows) after PTCS-BP; H: Subsequent PTCS-BP performed for the residual villous growing tumors (arrows point to the snare steel wire); I: PTCS showing unresected residual tumors (arrows) in the small ductal lumen.