What Is a Cholangiography?

Although X-ray examination is a common method for the diagnosis of biliary tract 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 biliary angiography site. The image can be clearly displayed on the X-ray film. This method is cholangiography.

Name: Cholangiography

category: X-ray

Normal cholangiography

The normal biliary tract looks smooth and neat 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 does not exceed 1 cm, and it gradually tapers down like a goose feather tube. You can also see the contrast agent entering the twelve fingers. intestinal.

Clinical significance of cholangiography

There are many methods of cholangiography, which are generally divided into two categories: excretory cholangiography and direct cholangiography.
Excretory biliary angiography: The use of oral or intravenous contrast agents (the principle of using contrast agents to take up liver cells and discharge them into the biliary tract) for biliary angiography. This angiography method is suitable for patients with normal organ function and no complications. Commonly used methods include oral cholecystography, intravenous cholangiography (common venography and drip venography), and oral and intravenous angiography.
Direct cholangiography: direct injection of contrast agent into the biliary tract through various channels for photography. Clinically used methods include percutaneous liver puncture cholangiography, endoscopic retrograde cholangiography, and laparoscopic cholangiography. , Surgical biliary angiography (intraoperative radiography, postoperative radiography), etc. The advantage of this type of contrast method is that the contrast agent directly reaches the lesion, and the contrast effect is ideal. It can clearly show the direction of the bile duct inside and outside the liver, the diameter of the tube is abnormal or narrow, the occlusion, the tumor of the biliary tract, and gallstones. The endoscope can be used for direct observation and retrograde angiography, and it is possible to understand the lesions near Ampulla's ampulla quite clearly. Biopsy of bile or duodenal lesions can also be taken directly.

Biliary angiography considerations

Contraindications before inspection:
(1) Do not take drugs containing iron, iodine, sodium, bismuth, silver, etc. 2 days before the investigation.
(2) Do not eat more fiber and non-digestible food one day before the angiography.
(3) One night before the radiography, eat less residue diet such as soy milk, noodles, porridge and so on.
(4) Avoid wearing clothes with more metal patterns on the day of inspection. Remove jewelry, belts, coins, keys and other items in the pocket that may cause artifacts before inspection.
(5) Fasting on the morning of the radiography, including boiling water and medicine.
(6) Patients need to undergo an iodine allergy test before angiography.
Requirement during examination: Patients only need to follow the doctor's guidance and cooperation.
Unsuitable people:
(1) Esophageal varices or stenosis.
(2) Allergy to contrast agent (lipiodol).
(3) Acute pancreatitis or acute attack of chronic pancreatitis.
(4) People with severe cardiovascular disease accompanied by cardiac insufficiency or frequent angina pectoris.
(5) Viral hepatitis and hepatitis B surface antigen positive (Australian anti-positive).
(6) People with mental disorders who cannot cooperate. (7) Acute biliary infection.

Cholangiography

(1) Do a good job of explanation so that patients can relieve their concerns and cooperate actively.
(2) Ask the patient's history carefully to see if the patient has a contraindication to cholangiography.
(3) Use the medical contrast agent to enter the biliary tract through a certain method and channel, so that the contour and lesion image of the biliary angiography site can be clearly displayed on the X-ray. Intravenous gallbladder and biliary angiography are intravenous contrast agents, which are not affected by the absorption of the gastrointestinal tract, and can quickly obtain results. Intravenous angiography generally shows the common bile duct and common hepatic duct 30-40 min after injection, and it becomes unclear later.

Cholangiography- related diseases

Mirizzi syndrome, acute cholecystitis and cholangitis in children, biliary peritonitis, pregnancy with acute cholecystitis, acute cholecystitis, primary sclerosing cholangitis, acute cholecystitis in children, duodenal diverticulum, chronic cholecystitis, hepatobiliary Tube stones

Cholangiography- related symptoms

Pigmented gallstones, gallbladder tenderness, biliary atresia, enlarged gallbladder, biliary ascariasis, biliary motor dysfunction, gallstones, biliary obstruction, gallstone
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