TECHNIC, INDICATIONS AND VALUE OF POSTOPERATIVE CHOLANGIOGRAPHY

Abstract

THE EXPLORATION of the liver and its excretory bile ducts by means of contrast roentgenography has developed into an exact science. Just as urograms have transformed urology from a suppositional to a precision specialty, so cholangiograms have displaced the haphazard methods which have been employed in recognizing pathologic dysfunctions of the biliary system. The importance of cholangiography cannot be overemphasized. HISTORICAL OBSERVATIONS The early literature on cholangiography contains sporadic reports from various parts of the world. Reich 1 in 1918 introduced a mixture of petrolatum and barium into an external biliary fistula and obtained an accurate roentgenographic pattern of the bile ducts. In January of 1922 Tenney and Patterson 2 visualized an incarcerated ampullary stone by introducing bismuth paste into a persistent external biliary fistula. Unfortunately the thick paste plugged the bile ducts, and the resulting cholangitis and cholemia did much to discourage further development of this procedure in