[Surgical treatment of tumors of the extrahepatic bile ducts. Report on 5 years].
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The Bayes-formula gives the possibility in ambiguous situations for diagnostic decisions to use the sensitiveness of findings for estimating the diagnostic probabilities. In such a case in differential-diagnostic questionings can be proceeded from the equal probability of the diagnoses so that the probabilities obtained by means of computation are alone based on the sensitiveness of findings and not on subjective estimations. Combinations of findings (patterns of findings) of any kind taken from positive and negative findings can be analysed. The advantage consists above all in the fact that the sensitiveness of findings may be evaluated controllable, reproducible and independent of the subjective experience. In addition to this there is a theoretical advantage that the process of the diagnostic decision becomes better understandable. Nevertheless it is to be emphasized that diagnostic decisions finally are based on subject-specific interpretations of the findings and formal criteria deliver only additional aids of decision.
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In obstructive biliary disease sonography proves to have a high diagnostic informative value. Dilatation of intra-and extrahepatic bile ducts is documented sonographically. In the majority of cases, analysis of sonographic findings will clarify the cause of biliary obstruction like cholecysto-cholangiolithiasis, carcinoma of the head of the pancreas, or various neoplastic disease in the area of the liver hilus. The obtained information is independent from contraindications like contrast medium allergies and severe parenchymal liver disease with impaired biliary secretion of contrast media.
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