Echoendoscopie et minisondes dans les tumeurs du hile hépatique
Endosonography and miniprobes in tumours of the hepatic hilum
Patients who present with painless jaundice and no culprit mass lesion on abdominal imaging pose a real diagnostic challenge. In this setting, ERCP is currently the procedure of choice, as it provides direct visualization of the biliary tree, as well as temporary biliary decompression when a stricture is encountered. Cholangiographic findings at ERCP, however, are not accurate enough to differentiate reliably between benign and malignant strictures, even with the addition of brushing and biopsy tissue sampling.
Due to the use of highfrequency probes, endoscopic ultrasound (EUS) and intraductal ultrasound (IDUS) are imaging modalities which can visualize tumours of the common bile duct more precisely than all other conventional imaging modalities.
However, EUS images alone are not able to distinguish patients with benign from those with malignant lesions reliably. EUS-FNA might be able to fill this gap offering the possibility to provide a tissue diagnosis even in small hilar tumours.
endosonography, hepatic hilum, miniprobes, Klatskin tumour