ASSESSMENT OF THE COURSE AND VARIATIONS OF THE HEPATIC-ARTERY IN BILE-DUCT CANCER BY INTRADUCTAL ULTRASONOGRAPHY

Background: We evaluated the course and variations of the hepatic arte ry in bile duct cancer using intraductal ultrasonography (IDUS). Metho ds: IDUS was used to demonstrate the course of the hepatic artery preo peratively in 20 patients with extrahepatic bile duct cancer, and the image was compared with angiographic and surgical findings. Results: I DUS was able to assess tumor invasion to the main branch of the right hepatic artery in all cases. However, it demonstrated only three cases in the left hepatic artery and four cases in the proper hepatic arter y. When the hepatic artery indicated re-entry or bifurcation on the ID US image, the proximal portion of re-entry or bifurcation was establis hed as the proper hepatic artery, but when it showed neither re-entry nor bifurcation it was established as the right hepatic artery. Conclu sions: IDUS demonstrated the main branch of the right hepatic artery i n all cases, but was not useful for demonstration of the left and prop er hepatic arteries. Correct assessment of re-entry and bifurcation wa s essential on IDUS images for making the distinction between the righ t hepatic artery and the proper hepatic artery.