肝外胆管上段肿瘤超声诊断及ICCEUS辅助诊断：病例分享

The following case is about a 71-year-old elderly male with a clinical diagnosis of tumor in the upper segment of the extrahepatic bile duct. Routine ultrasound showed unclear structures in the hepatic hilum and could not determine if the left and right hepatic ducts were connected. Due to significant dilation of the left intrahepatic bile duct, ultrasound-guided left intrahepatic bile duct PTCD (percutaneous transhepatic cholangiography and drainage) was performed. Simultaneously, ICCEUS (intraoperative contrast-enhanced ultrasound) was performed through a drainage tube. We found that the contrast agent filled the left intrahepatic bile duct well and partially reached the right hepatic duct. However, compared to the left hepatic duct, the right hepatic duct at the hepatic hilum appeared narrower, indicating a possible obstruction in the site where the left and right hepatic ducts communicate, suggesting that the tumor may have involved the right hepatic duct.