Foreword
The pancreatobiliary region has one of the most complicated structures and physiological functions in our body.
Endoscopic procedure in the region thus requires rather complicated techniques. This makes it difficult and time-
consuming to explain pancreatobiliary diseases or pancreatobiliary endoscopy to patients and their families, or to
deliver correct information to medical staff during training.
This book was specifically written to eliminate such difficulties and to increase the understanding and provision of
medical information related to pancreatobiliary diseases and pancreatobiliary endoscopy in the shortest time possible.
Much time and effort has been invested in publishing this book so that medical staff specializing in pancreatobiliary
diseases, e.g. specialists, fellows, residents, nurses and medical students, will be able to more easily understand the
corresponding diseases and a variety of endoscopic treatments in a short period of time, while patients and their
families will be able to gain better insights into the pancreatobiliary endoscopy needed by the patients.
My sincere thanks go to Professor Seok Ho Dong, the editor-in-chief, who has made arduous efforts for this book, and to
all other editors who have contributed.
Sun-Joo Kim, M.D., Ph.D.
President
The Korean Society of Pancreatobiliary Diseases
Preface
"Seeing is learning"
This is the creed of the authors bore in mind when they came together and agreed to bring out this kind of book. This
volume contains illustrated figures of pancreatobiliary diseases as well as relevant ERCP procedures. You will be
getting familiar with the anatomy and diseases of the pancreas and biliary tract while looking at the detailed
illustrations. Besides, you will be able to understand various ERCP procedures with ease. The authors carried out
painstaking search for figures from books or through the web and tried to put as many figures as possible. You can also
get some useful information on commercially available accessories for ERCP in the final chapter. All the figures in
this volume were modified and redrawn one by one to make the best illustrations.
I would like to express my hearty thanks to all the authors for their exceptional contributions and to the artist who
dedicated himself to elaborate computer graphics.
Seok Ho Dong, M.D., Ph.D.
Editor-in-chief
Editors
Seok Ho Dong, M.D., Ph.D.
Professor
Division of Gastroenterology,
Department of Internal Medicine,
Kyung Hee University College of Medicine
Seoul, Korea
Hong Sik Lee, M.D., Ph.D.
Professor
Division of Gastroenterology,
Department of Internal Medicine,
Korea University College of Medicine
Ansan, Korea
Jong Ho Moon, M.D., Ph.D.
Associate Professor
Division of Gastroenterology,
Department of Internal Medicine,
Soonchunhyang University College of Medicine
Bucheon, Korea
Do Hyun Park, M.D., Ph.D.
Assistant Professor
Division of Gastroenterology,
Department of Internal Medicine,
University of Ulsan College of Medicine
Seoul, Korea
Sang-Heum Park, M.D.
Professor
Division of Gastroenterology,
Department of Internal Medicine,
Soonchunhyang University College of Medicine
Cheonan, Korea
Seung Woo Park, M.D., Ph.D.
Associate Professor
Division of Gastroenterology,
Department of Internal Medicine,
Yonsei University College of Medicine
Seoul, Korea
Kyo-Sang Yoo, M.D., Ph.D.
Associate Professor
Division of Gastroenterology,
Department of Internal Medicine,
Hallym University College of Medicine
Anyang, Korea
도서목차
Part I
Normal and Variant Anatomy of Pancreaticobiliary Tract
01 _Overview of bile duct and pancreas 2
02 _ Segments of liver 7
03 _Artery and vein of pancreaticobiliary system 12
04 _Biliary tract 15
05 _ Pancreas 24
06 _Gallbladder and cystic duct 30
Part II
Ampulla of Vater
01 _Major papilla 34
02 _ Histologic structure 36
03 _Y, V, and U type 40
04 _Periampullary diverticulum 42
05 _ Ampulla of Vater cancer 43
Part III
Biliary Tract
01 _Choledochal cyst 46
02 _ Types of choledochocele 47
03 _ Duplication of extrahepatic bile duct 49
04 _Anomalous pancreaticobiliary union (APBU) 50
05 _Stones on biliary tract 55
06 _ Bile duct injury 56
07 _Postsurgical benign biliary stricture 57
08 _ Intrahepatic biliary disease 58
09 _Bile duct cancer 59
10 _Klatskin tumor (Hilar cholangiocarcinoma) 62
11 _ Extrahepatic bile duct stricture 64
12 _ Gallbladder cancer 65
Part IV
Pancreas
01 _Pancreas divisum 68
02 _ Annular pancreas 70
03 _Chronic pancreatitis 72
04 _Pancreas cystic lesion 76
05 _ Pancreatic cancer 79
Part V
Techniques of ERCP
01 _Intubation of duodenoscope 82
02 _ Cannulation 88
03 _ Altered anatomy 106
04 _Precut papillotomy and infundibulotomy 130
05 _Endoscopic sphincterotomy (EST) 143
06 _ Drainage 153
07 _Stone extraction 168
08 _ Papillectomy 184
Part VI
Sphincter of Oddi
01 _Normal anatomy 186
02 _ Relaxation and contraction 187
03 _Stenotic and dysfunctional sphincter of Oddi 188
04 _Sphincter of Oddi manometry 189
Part VII
ERCP Accessories
01 _Catheters 192
02 _ Guide wires 195
03 _Sphincterotomes 197
04 _Needle knives 199
05 _ Dilating balloons 200
06 _Extraction baskets 202
07 _ Extraction balloons 205
08 _Lithotriptors 207
09 _Naso-biliary and naso-pancreatic drainage 208
10 _ Cytology brushes 209
11 _ Plastic stents 210
12 _ Metal stents 213