[Practice-oriented method of cholangiography].

Abstract

The authors present their methodology of cholegraphy which was tested in practical routine work under in most cases examination conditions of an outpatient department with orientation to optimized relations between expense, risk and utility. The peculiarities of the methodical and tactical procedure are described in detail. A radiological representation of the biliary system should be performed only when there is no possibility to sonography and when there are discrepancies between its result and clinical picture, respectively. The oral cholegraphy is regarded as basis examination. When it has a negative result and when there is a congruity to the clinical findings (especially confirmation of the symptom colic) a surgical intervention seems to be justified. The intravasal application of a contrast remedy should in the interest of the patient be performed per infusionem, in order to keep the risk in justifiable limits. For the same reason a very strong indication is necessary. It is primarily used in disturbances of the enteral resorption, after cholecystectomy as well as in certain blood-chemical changes which suggest a severe disturbance of the hepatobiliary system. Secondarily it is used as second examination for further clarification of the picture of the disease. Here the decision must be rendered subject to the situation in the individual case, since in a series of pathological conditions a reduction of the quantity of the contrast remedy becomes necessary.