[Accuracy of peroperative study in the diagosis of bile duct stones and papillary obstructions].

The following tests were evaluated during biliary tract surgery: pressure controlled cholanlgiography, pressure measurement in the common duct, flow measurement through the papilla before and after administration of cholecystokinin. In a retrospective series of 122 patients with duct stones cholangiography was most accurate in detecting stones: 98%. In a prospective and retrospective series of totally 183 patients with obstruction at the papilla the following accuracy in detecting obstructions was achieved: cholangiography 72%, pressure measurement 72%, flow measurement 89%, combination of the tests 94%. In addition the importance of distinguishing a papillary spasm from an organic obstruction was shown with the cholecystokinin test. Cholangiography is adequate for the diagnosis of duct stones. However, additional measurement of pressure and flow is necessary for the diagnosis of obstructions at the papilla.