Cholangiography

Cholangiography is a contrast X-ray technique used when patients suspected of having gallstones cannot swallow or keep down tablets for HOLECYSTOG-RAPHY. It is often carried out during gall bladder removal to ensure that no stones have been left behind in the bile ducts. Cholangiography may also be used when people whose gall bladder has been removed have persistent symptoms suggesting the presence of small stones in the bile ducts that were not detected or had not formed when the surgery was performed.

A solution visible on X-ray may be injected into a vein, to be excreted by the liver into the bile ducts several hours later. Or if may be injected directly into the bile ducts, either via an endoscope (a viewing instrument used for internal examination of body cavities and hollow organs) passed through the mouth and stomach into the duodenum (first part of the small intestine), or through a fine needle inserted into the abdomen through the skin. Once the bile ducts are filled with X-ray-visible solution. X-rays will reveal any stones present.

Preparation

• An intravenous antibiotic may be given every four to six hours during the 24 hours before the test.
• A few minutes before the test begins a sedative may be given.

Risks

• Blood poisoning and bile peritonitis are rare but serious complications of this procedure.
• Dye occasionally leaks from the liver into the abdomen, and there is a slight risk of bleeding or infection.

Precautions

Patients should report allergic reactions to:

• Dyes used in medical tests.
• Shellfish.
• Anesthetics.

Cholangiography should not be performed on anyone who has:

• Inflammation of the bile ducts.
• A serious uncorrectable or uncontrollable bleeding disorder.
• Massive ascites.

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