The Clinical Evaluation of operative cholangiography

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Operative cholangiography was performed selectively on 86 cases: 30 cases with choledocholithiasis, 23 cases with cholecystitis with or without stones, 13 cases with postcholecystectomy syndrome, 13 cases with malignant tumors of the bilary tract system, and 7 cases with other diseases of the biliary tract system.Marked dilatation of the cystic duct was noted very frequently in the operative cholangiograms of choledocholithiasis. This was confirmed by measuring the diameter of the cystic duct directly at cholecystectomies. Mean diameter of the cystic ducts without stones in the common bile duct was 3.4mm, while 19 cases of choledocholithiasis showed the diameter of 7.4mm.In patients with cholecystitis with or without stones, the most frequent indication for operative cholangiography was dilatation of the common bile duct. Dilatation of the cystic ducts, history of jaundice and small gall stones in the gall bladder were the next frequent indications. In a few cases, the anatomical location and the relation of the biliary tract to the surrounding organs were confirmed by operative cholangiography.Clinical studies of patients with postcholecystectomy syndrome revealed that if previous operations had been done carefully, the occurance of the syndrome could be minimized. Operative cholangiography was helpful in obtaining important findings of the syndrome necessary for the proper treatment.In malignant tumors involving the common bile duct, such as cancer of the head of the pancreas, cancer of the papilla Vaterii, and cancer of the gall bladder, typical cholangiographic patterns of V or U shaped endings were observed. No specific patterns were showen in the benign stricture of the common bile duct.From studies of 86 cases, the importance of operative cholangiography in the diagnosis and the treatment of biliary tract diseases was emphasized.
財団法人日本消化器病学会の論文

The Clinical Evaluation of operative cholangiography

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