Although X-ray examination is a common method for the diagnosis of biliary diseases, some patients cannot be clearly displayed on ordinary X-ray films. This requires the use of medical contrast agents to enter the biliary tract through certain methods and channels, so that the contours and lesions of the cholangiography site The image can be clearly displayed on the X-ray film. This method is cholangiography. Direct cholangiography is a method of direct injection of contrast agent into the biliary tract for photography. The methods commonly used in clinical practice include percutaneous transhepatic cholangiography, endoscopic retrograde cholangiography, laparoscopic cholangiography, and surgery. Cholangiography (intraoperative angiography, postoperative angiography), etc.

Basic Information

Specialist classification: Digestive examination classification: X-ray

Applicable gender: whether men and women apply fasting: not fasting

Tips: Do not take iron, iodine, sodium, strontium, silver and other drugs for 2 days before the investigation. Normal value

The normal biliary tract looks smooth and tidy on the X-ray film. You can see the left and right hepatic ducts and some small branches. The diameter of the common bile duct is less than 1cm. It is tapered downwards like a goose-brown tube. You can also see the contrast agent entering the twelve fingers. intestinal.

Clinical significance

There are many methods of cholangiography, which are generally divided into two categories: excretory cholangiography and direct cholangiography.

Excretory cholangiography is the use of oral or intravenous contrast agents (the use of contrast agents for the uptake of liver cells into the biliary tract). This method of imaging is suitable for patients with normal function of other organs and without complications. Commonly used methods include oral gallbladder angiography, transvenous cholangiography (common venography and infusion venography), and oral and venous angiography.

Direct cholangiography is a method of direct injection of contrast agent into the biliary tract for photography. The methods commonly used in clinical practice include percutaneous transhepatic cholangiography, endoscopic retrograde cholangiography, laparoscopic cholangiography, and surgery. Cholangiography (intraoperative angiography, postoperative angiography), etc. The advantage of this type of contrast method is that the contrast agent directly reaches the lesion site, and the contrast effect is ideal. The biliary approach to the liver and the outside, the abnormal or narrow diameter, the occlusion, the biliary tumor, and the gallstone can be clearly displayed. The use of endoscopes for direct observation and retrograde angiography can clearly understand the lesions near the abdomen of the ampulla, and can also directly take biopsy of bile or duodenal lesions.

Precautions

Forbidden before examination: Do not take iron, iodine, sodium, strontium, silver and other drugs for 2 days before the examination. It is not advisable to eat more fiber and non-digestible foods one day before the angiography. One night before the angiography, eat less slag diet such as soy milk, noodles, porridge and so on. On the day of inspection, you should avoid wearing clothes with more metal patterns. Before the inspection, remove the jewelry, belts, coins in the pockets, keys, and other items that may cause artifacts. Fasting in the morning of the angiography, including boiling water and medicine. Patients with iodine allergy test before angiography.

Requirements for examination: Patients only need to follow the doctor's instructions to cooperate.

Inspection process

(1) Do a good job of explaining the work so that the patient can dispel concerns and actively cooperate.

(2) Carefully ask the medical history to see if the patient has contraindications for cholangiography.

(3) Using a medical contrast agent to enter the biliary tract through certain methods and channels, so that the contour and lesion image of the cholangiography site can be clearly displayed on the X-ray film. Intravenous gallbladder and cholangiography are intravenous injections, which are not affected by the absorption of the gastrointestinal tract, and can quickly produce results. Intravenous angiography is generally 30-40 minutes after injection, the common bile duct and total hepatic duct display are clearer, and gradually become unclear.

Not suitable for the crowd

Contrained people: (1) The esophagus has varicose veins or stenosis. (2) Allergic to contrast agents (iodine oil). (3) Acute episodes of acute pancreatitis or chronic pancreatitis. (4) Patients with severe cardiovascular disease accompanied by cardiac insufficiency or frequent angina pectoris. (5) Viral hepatitis and hepatitis B surface antigen positive (Aussie anti-positive). (6) Those who are mentally abnormal and unable to cooperate. (7) Acute biliary infection.

Adverse reactions and risks

Nothing.