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| Davide Colombi a , ∗, Giovanni Aragona b , Flavio Cesare Bodini a , Adriano Zangrandi c , Nicola Morelli a , Emanuele Michieletti a |
a Department of Radiology, Radiology Unit, “Guglielmo da Saliceto” Hospital, Via Taverna 49, 29121 Piacenza, Italy
b Department of Internal Medicine, Gastroenterology and Hepatology Unit, “Guglielmo da Saliceto” Hospital, Via Taverna 49, 29121 Piacenza, Italy
c Department of Oncology and Hematology, Pathology Unit, “Guglielmo da Saliceto” Hospital, Via Taverna 49, 29121 Piacenza, Italy
∗ Corresponding author.
E-mail address: D.Colombi@ausl.pc.it (D. Colombi). |
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Abstract The definition of biliary stricture in patients with post-surgical biliary or enteric anatomy is challenging, due to limitations in accessing biliary system with a peroral approach. In these cases, percutaneous route is an option to obtain diagnosis and to steer patients’ therapy [1] . However, cytologic findings obtained from bile and biliary brushing during percutaneous transhepatic cholangiography (PTC) demonstrated low sensitivity (43%) and high rate of inadequate specimens (21%) [2] . Nevertheless, cholangioscopy can be performed through percutaneous transhepatic access to obtain endoscopic visualization of the biliary tract and to guide tissue sampling with biopsy forceps [1,3] . Here, we report the diagnosis of adenocarcinoma of the ampullary region achieved at surgical specimen after endoscopic biopsy of dysplastic adenomatous alterations at the distal common bile duct obtained through percutaneous transhepatic cholangioscopy (PTCS) in a patient affected by worsening jaundice with previous bariatric biliopancreatic diversion.
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2019, Vol. 18 
