[Echography in jaundice caused by primary neoplasms of the bile ducts]

A retrospective study is reported, carried out on 45 patients with primary carcinoma of the biliary tree. The purpose of the study was to test the effectiveness of US in accurately demonstrating the kind of jaundice (diagnostic level I), the site (diagnostic level II) and etiology of the biliary obstruction (diagnostic level III). A carcinoma of the gallbladder with common bile duct infiltration was found in 23 patients, while 22 were affected by primary bile duct carcinoma. In the 23 patients with carcinoma of the gallbladder, the kind of jaundice was correctly diagnosed in 100% of cases, while the site and cause of obstruction were detected in 18 (78%) and 10 (43%) cases respectively. In the 22 cases of primary bile duct carcinoma, the kind of jaundice was accurately demonstrated in 21 cases (95%); the site and etiology of the obstruction in 19 (86%) and 11 (50%) patients respectively. Therefore, in a total number of 45 patients examined, success rate was 98% in diagnostic level I, 80% in diagnostic level II, and 47% in diagnostic level III. Ultrasonography proves thus to be almost completely reliable in diagnostic level I, and very reliable in diagnostic level II; so much so that it can, alone, direct the surgeon in case of an emergency. Results are less satisfactory in diagnostic level III. Therefore, if details of the obstructive lesion and of the biliary tree are required for the planning of definitive treatment, either PTC, ERCP, or CT should be performed.