Case Report
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World J Gastroenterol. Jul 21, 2013; 19(27): 4427-4431
Published online Jul 21, 2013. doi: 10.3748/wjg.v19.i27.4427
Intrahepatic cholangiocarcinoma diagnosed via endoscopic retrograde cholangiopancreatography with a short double-balloon enteroscope
Tsukasa Ikeura, Masaaki Shimatani, Makoto Takaoka, Mitsunobu Matsushita, Hideaki Miyoshi, Akiko Kurishima, Kimi Sumimoto, Sachi Miyamoto, Kazuichi Okazaki
Tsukasa Ikeura, Masaaki Shimatani, Makoto Takaoka, Mitsunobu Matsushita, Hideaki Miyoshi, Akiko Kurishima, Kimi Sumimoto, Sachi Miyamoto, Kazuichi Okazaki, Third Department of Internal Medicine, Kansai Medical University, Osaka 573-1191, Japan
Author contributions: Ikeura T, Shimatani M, Takaoka M, Miyoshi H, Kurishima A, Sumimoto K and Miyamoto S performed endoscopic retrograde cholangiopancreatography with a double-balloon enteroscope; Ikeura T wrote the manuscript; and Ikeura T, Shimatani M, Matsushita M and Okazaki K revised the manuscript.
Correspondence to: Tsukasa Ikeura, MD, PhD, Third Department of Internal Medicine, Kansai Medical University, 2-3-1 Shinmachi, Hirakata, Osaka 573-1191, Japan. ikeurat@takii.kmu.ac.jp
Telephone: +81-72-8040101 Fax: +81-72-8042061
Received: January 9, 2013
Revised: April 14, 2013
Accepted: May 9, 2013
Published online: July 21, 2013
Processing time: 192 Days and 12 Hours
Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) using a double-balloon enteroscope (DBE) in patients with bowel reconstruction due to a previous abdominal surgery is now widely accepted. In particular, a short DBE, which has a 2.8-mm working channel and 152-cm working length, is useful for ERCP because of its good rotational and straightening ability and the availability of various conventional ERCP accessories through the working channel. Herein we report a case of intrahepatic cholangiocarcinoma via ERCP with a short DBE. This is the first report in which the pre-cutting and the brush cytological examination were performed successfully under a DBE to diagnose intrahepatic cholangiocarcinoma pathologically. The short DBE allowed us to perform all diagnostic and therapeutic procedures accepted in conventional ERCP in patients with surgically altered anatomies.

Keywords: Double-balloon enteroscope; Diagnosis; Endoscopic retrograde cholangiopancreatography; Intrahepatic cholangiocarcinoma; Cytology

Core tip: This is the first report in which the pathological diagnosis of intrahepatic cholangiocarcinoma could be made using the brush cytological examination via endoscopic retrograde cholangiopancreatography with a double-balloon enteroscope (DB-ERCP). In this paper, the methods of these procedures during DB-ERCP such as biliary cannulation, pre-cutting, and cytological examination are demonstrated in detail. Therefore, we believe that this paper must expand awareness of the utility of DB-ERCP for diagnosis of pancreatobiliary disease in patients with bowel reconstruction due to a previous abdominal surgery.