Diagnosis of bile duct and gallbladder carcinoma by percutaneous transhepatic cholangioscopy

Recently the technique of imaging diagnosis has been developed and biliary tract carcinomas without any symptoms can be diagnosed by US, CT and cholangiography, but preoperative definitive diagnosis should be carried out by percutaneous transhepatic cholangioscopy (PTCS) or percutaneous transhepatic cholecystoscopy (PTCCS) especially in cases of minute lesions, superficial spreading type carcinomas or biliary tract carcinomas complicated with gall stones. Operative procedures, such as hepatectomy, bile duct resection and/or pancreatoduodenectomy, have to be decided before the operation according to the extent of cancer which is diagnosed by percutaneous transhepatic cholangioscopic biopsy.