Cinecholangiographic Observations after Bile Duct Surgery

Abstract

Solitary film cholangiograms and cinecholangiograms were made using indwelling T-tubes on forty-five patients after biliary tract surgery. Conventional cholangiograms demonstrated various abnormalities in fourteen patients: filling defects, deformities, and apparent obstructions to bile flow. Even repeated examination failed to clarify their significance. Cinefluorography showed them to be due to clinically insignificant anatomic and physiologic mechanisms or to technical errors during spot film examination. In all the patients concerned, removal of the T-tube was followed by complete recovery. Cinecholangiography cannot be regarded as a substitute for conventional cholangiography but it adds significantly to the information gained by the latter.

Observations were also made as regards the information cineradiology offered on the kinetics, sphincteric activity, and bile flow of the surgically explored biliary tract. After transduodenal sphincterotomy not exceeding 20 millimetres in length the cinefluorographic behaviour of the choledochoduodenal junction was closely similar to that of a normal, intact sphincter apparatus. The responses to morphine and nitroglycerine were also similar. Whether this cineradiographic normalization of the bile flow after sphincterotomy is permanent or transitory is a matter for further study.

Index-words:

• Bile ducts
• biliary tract
• cholangiography
• cinefluorography