Mobilization cholangiography

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Abstract

Determination of the state of the biliary tract and the terminal part of the common bile duct is one of the most difficult issues of intraoperative diagnosis in complicated cholecystitis. Currently, none of the surgeons doubts the need for intraoperative cholangiography and its value. It is she who allows to identify in many patients the presence of calculi in the biliary tract, to determine the degree of expansion of the common bile duct and bile hypertension, the state of the terminal part of the common bile duct. However, the analysis of radiographs performed during 170 surgical interventions for various degrees of stenosis of the large duodenal papilla showed that even this most reliable method of intraoperative diagnosis has a significant drawback.

About the authors

O. S. Kochnev

Kazan State Institute for Advanced Training of Doctors named after V. I. Lenin

Author for correspondence.
Email: info@eco-vector.com

Department of Emergency Surgery

Russian Federation, Kazan

V. N. Biryaltsev

Kazan State Institute for Advanced Training of Doctors named after V. I. Lenin

Email: info@eco-vector.com

Department of Emergency Surgery

Russian Federation, Kazan

References

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2. Fig. 1. Intraoperative cholangiography before mobilization of the duodenum. The common bile duct is enlarged to 1.2 cm. The contrast agent enters the duodenum, and the shadow of the contrast in the intestine is superimposed on the shadow of the terminal part of the common bile duct and the Wirsung duct, simulating the insufficiency of the BDS and the stricture of the Wirsung duct.

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3. Fig. 2. Mobilization cholangiography. The shadow of the terminal part of the common bile duct, its ampullar part and the final part of the Wirsung duct are clearly revealed. There is reflux of the contrast agent in the Wirsung duct due to stenosis of the OBD.

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