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KMID : 0381219720040100656
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Journal of RIMSK
1972 Volume.4 No. 10 p.656 ~ p.662
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OPERATIVE CHOLANGIOGRAPHY
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Abstract
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Operative cholangiography is an essential procedure for a successful biliary surgery. Unnecessary common duct exploration can be avoided and chance of overlooking residual stone is greatly reduced to about 1 per cent. As the incidence of choledocholithiasis and intrahepatic stone is much higher in Koreans than in western peoples, the necessity of operative cholangiography is more urgent in biliary surgery in this country. With this diagnostic armamentarium, intraductal stones can be easily detected and the site of obstructive lesion is clearly depicted. Prolongation of surgery for about 10 to 15 minutes, which is usually needed for this procedure, is offset by the vital information gained from this examination.
If operative cholangiography is to be most promising, a well-coordinated teamwork is mandatory. Every effort should be made to prevent introducing air into the bile duct, and the concentration and amount of the contrast medium should be properly controlled to obtain an optimal contrast as well as adequate filling of the biliary tree. Too dense a contrast medium frequently obscures fairly large calculi in a dilated common bile duct. An insufficient amount of the contrast medium results in incomplete filling of the biliary radicals, and thus misinterpretation or overlooking of a significant obstructive lesion may be incurred.
A simple formula of estimating optimal concentration and dose of the contrast medium is suggested as follows:
Concentration=25% X D Dose=lOml. X D² where D is the diameter of the common bile duct expressed in centimeter.
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KEYWORD
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