J.Jpn. Surg. Soc.. 82(9): 1085-1088, 1981

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Report on the annual meeting

PRECISE EXAMINATIONS DURING OPERATION OF BILIARY TRACT

Though percutaneous transhepatic cholangiography, endoscopic retrograde cholangio-pancreaticography, echo examination, etc. have been developed recently, it still remains important to employ precise examinations during operation in order to avoid residual or recurrent stones after operation of cholelithiasis.
In our department, routine operative cholangiography and biliary radiomanometry, and, if necessary, suitable biliary fiberscopy are performed in principle during operative procedure of cholelithiasis. The method of operative cholagiography is to take a series of three films changing the dose and density of contrast material by using a film box capable to exchange films with brief manipulation. This operative cholangiography made able to increase diagnostic accuracy especially at the portion of terminal bile duct and decrease the number of exposing times. On the other hand, a new radiomanometry of biliary pressure, i.e. variable loading method was devised to express the functional state of the papilla of Vater with concrete values. The method is so efficient to diagnose the passage disturbance of the papilla that it has become easy to decide the indication of bile duct drainage. The above mentioned examinations have been employed in about 350 cases since 1973, therefore we have not experienced any case with retained or recurrent stones until now.

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