LIVER BILLIARY TRACT 14 investigations

13.3 INTRAVENOUS CHOLECYSTOGRAPHY

When there is a failure of the gallbladder to be visualized  after

oral cholecystography, intravenous cholecystography is indicated.

*  It  is  also  a  means for  visualization  of  bile  ducts  in

   cholecystomized patients.

*  It is of little value, if bilirubin is greater than 3.5 mg/100

   ml.

13.4 PERCUTANEOUS TRANSHEPATIC CHOLANGIOGRAPHY AND ENDOSCOPIC

Retrograde   Cholangiography  are  indicated  in   patient   with

jaundice.

13.5 T-TUBE CHOLANGIOGRAPHY

This is frequently performed in the operating room at the time of

exploration  of the biliary tract with injection of radio  opaque

material either inot the cystic duct or into the T-tube placed in

the common duct.

*  It can also be used in patients postoperatively

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LIVER BILLIARY TRACT 13 Investigations

13. DIAGNOSTIC TESTS for GB Disorders

13.1 ROUTINE ABDOMINAL X-RAYS

Plain films are indicated in biliary tract disease, since biliary

calculi in upto 20% of cases are calcified. Gallstones visibility

is denpendent upon the amount of calcium present in the stone. 

Ultrasonography  has  been adopted as  the  principle  diagnostic

test.

13.2 ORAL CHOLECYSTOGRAPHY

After  ingestion of telepaque 12 hours earlier, visualization  of

the normal gallbladder takes place.

*  Subsequent  to  the  ingestion of a  fatty  meal,  contraction

   begins  promptly  and within 40 minutes,  the  gallbladder  is

   reduced  to  at least one-third of one-fourth  of  its  normal

   size.

*  An abnormal cholecystogram may demonstrate poor  visualization

   of  the  gallbaldder  or presence of filling  defects  due  to

   presence of calculi or tumours.

*  Non-visualization may be due to :

   *  Failure to retain the oral medication

   *  Faulty absorption such as with pyloric obstruction

   *  Hepatic dysfunction

   *  Hepatic or cystic duct obstruction

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