Natsume Makoto, Sano Hitoshi, Fukusada Shigeki, Kachi Kenta, Inoue Tadahisa, Anbe Kaiki, Nishie Hirotada, Nishi Yuji, Yoshimura Norihiro, Mizushima Takashi, Okumura Fumihiro, Miyabe Katsuyuki, Naitoh Itaru, Hayashi Kazuki, Nakazawa Takahiro
Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, Japan.
Nihon Shokakibyo Gakkai Zasshi. 2013 May;110(5):825-32.
Diagnosis and treatment of biliary tract disease requires an intraductal radiocontrast agent. Although iodine-based contrast medium is commonly used, some patients show severe allergy to iodinated contrast agent. We have retrospectively reviewed the usefulness and safety of gadolinium as an alternative radiocontrast agent in 3 patients with allergy to iodine-based contrast medium in the diagnosis and treatment of biliary tract diseases. In case 1, percutaneous transhepatic biliary drainage and cholangiography were performed successfully and it was possible to visualize an intrahepatic bile duct stone. Percutaneous transhepatic cholangioscopic lithotomy was performed and the intrahepatic bile duct stone was removed. In case 2, endoscopic biliary lithotripsy was performed. In case 3, percutaneous transhepatic cholangiography and cholangioscopy provided a diagnosis of moderately differentiated carcinoma. He underwent pancreatoduodenectomy. Postoperative cholangiograms were also obtained successfully. Gadolinium contrast agent is an alternative to iodine-based cholangiography for the patients with allergy to iodine.
