A PROSPECTIVE STUDY TO ASSESS SAFETY AND EFFICACY OF USING AIR CHOLANGIOGRAPHY IN PATIENTS WITH HILAR STRICTURES, CHOLANGIOCARCINOMA IN CHD SECONDARY TO CARCINOMA GALL BLADDER

Aims:

A prospective study to assess the safety and efficacy of using air for cholangiography in patients with hilar strictures, high cholangio carcinoma in CHD and CHD strictures secondary to carcinoma gall bladder.

Methods:

82 patients, from 1^st March 2015 to 31^st March 2017, who came with obstructive jaundice for stenting with strictures at high CHD or hilum (Type I and Type II Strictures only) due to Cholangiocarcinoma and to carcinoma gall bladder were included in this study. 10cc of air was injected slowly and the ductal anatomy outlined. Ease of identification of various segments of Liver, length of stricture, proximal limit of the stricture, possibility of placing stents, risk of cholangitis and complications was studied.

Results:

Total cases- 82. Etiology: Carcinoma GB – 52 (63.4%); Hillar Type I-24 (29.2%), Hillar Type II – 6 (7.3%).

Successful normal cannulation at ERCP – 68 (82.9%), Precut Used – 14 (17%)

Ductal anatomy outlined – 82 (100%).

Proximal end of stricture identified – 82 (100%).

Classification of stricture possible – 82 (100%).

Dilatation and stenting possible: 78 (95.1%)

Complications: Air embolism – 0 (0%), Cholangitis – 0 (0%)

Affording patients, plastic 10 Fr. stents were placed

Days of hospitalization – 2 (1 to 5)

Conclusions:

Air cholangiography is a feasible and safe option in high CHD and Hillar bile duct malignant strictures.

High success of identifying ductal anatomy and successful placement of stents in the desired segment is possible.

Complications are very rare and no case of air embolism was noted in our study.