Improved oral excretory cholecystocholangiography.

A new improved technique for the visualization of intrahepatic bile ducts with oral contrast agent has been developed. The right lateral decubitus position was employed to avoid drainage of contrast medium from the common bile duct into the duodenum. 0.2-0.3 microgram/kg of Caerulein was injected intramuscularly (350 cases) or 0.02 microgram/kg of Kinevac was injected intravenously (15 cases) to induce rapid contraction of the gallbladder. The extruded contrast medium, which would normally flow into the duodenum, flowed backward into the intrahepatic bile ducts due to gravity. With this technique, improved visualization of intrahepatic bile ducts was achieved with use of oral contrast medium; it also obviated the problem of colonic gas overlapping the gallbladder and gallstones in cholecystography.