Contact double-contrast cholangiography.

Recently operative cholangiography has become an essential step in biliary surgery. However, an usual technique in which x-ray film is set beneath the patient has its limitation in visualization of fine changes. The author devised a new technique to resolve this problem. A triangular mammography film designed for good positioning is vaccum-packed, coupled with an intensifying screen of the same size, and then is sterilized in advance. Barium solution mixed with Gascon drop (a defoaming agent) is used as contrast material. The duodenum and head of the pancreas are mobilized. Usual cholangiography is performed at first, introducing angiographic media through a catheter placed into the catheter placed into the common duct via the cystic duct. After this study a triangle film pack is set beneath the second part of the duodenum. Two to three milliliters of barium, 1 to 2 ml of Gascon, and 15 ml of air are pushed in; thus a contact double-contrast cholangiogram is obtained. This technique promises clear demonstration of the distal bile duct without risk, and even fine mucosal plicae may be discernible in the film.