cholangiography

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cholangiography

 [ko-lan″je-og´rah-fe]
x-ray examination of the bile ducts, using a radiopaque dye as a contrast medium. In the intravenous method, the dye is administered intravenously and is excreted by the liver into the bile ducts. X-ray films are taken at 10-minute intervals as the dye is excreted via the cystic, hepatic, and common bile ducts into the intestinal tract. The excretion is usually completed within 4 hours. Preparation of the patient for the intravenous method requires restriction of fluids to concentrate the dye and may also include cleansing of the intestinal tract on the day prior to the examination with a laxative or enema so that fecal material and gas will not obscure the biliary tract.

Sometimes cholangiography is done after surgery of the gallbladder and biliary tract. In this method the radiopaque dye is injected directly into a tube that has been left in the biliary tract since the time of surgery. Films are taken immediately after the dye is injected. If no obstruction is present, the biliary structures fill readily and rapidly empty into the intestinal tract.

When it is necessary for the surgeon to locate gallstones or other obstructive conditions at the time that surgery is being performed, the dye may be injected directly into the bile ducts. Films are taken in the operating room, and obstructions not otherwise discernible can be located and corrected while the patient is still anesthetized.

A patient who is jaundiced cannot undergo either intravenous cholangiography or oral cholecystography. An alternative route for the injection of the contrast dye and visualization of the biliary system is percutaneous transhepatic cholangiography. Under fluoroscopic control, a needle is introduced through the skin and into the liver where the contrast material is deposited. Obstructed and distended bile ducts can then be visualized. After visualization the ducts can be drained via the needle.
Percutaneous transhepatic cholangiography. The aspirating needle is passed through the patient's skin and liver tissue until the tip penetrates one of the hepatic ducts. Radiopaque medium is then instilled into the biliary tree to enhance radiographic visualization. From Malarkey and McMorrow, 2000.
fine needle transhepatic cholangiography (FNTC) transhepatic cholangiography performed by means of a very fine, highly flexible steel needle (skinny needle).
percutaneous transhepatic cholangiography see cholangiography.
transhepatic cholangiography cholangiography after introduction of radiopaque medium into the biliary system by percutaneous puncture of a bile duct.
transjugular cholangiography cholangiography after catheterization of a hepatic vein via the internal jugular vein in the neck and entry into a bile duct by percutaneous puncture across the wall of the hepatic vein.

chol·an·gi·og·ra·phy

(kō-lan'jē-og'ră-fē),
Radiographic examination of the bile ducts with contrast medium.
[chol- + G. angeion, vessel, + graphō, to write]

cholangiography

/cho·lan·gi·og·ra·phy/ (kol-an″je-og´rah-fe) radiography of the bile ducts.

cholangiography

(kō-lăn′jē-ŏg′rə-fē)
n.
X-ray examination of the bile ducts after the administration of a radiopaque contrast medium.

cho·lan′gi·o·graph′ic (-ə-grăf′ĭk) adj.

cholangiography

[kōlan′jē·og′rəfē]
a special roentgenographic test procedure for outlining the major bile ducts by the IV injection or direct instillation of a radiopaque contrast material. See also cholecystography.
method For IV cholangiography the contrast agent is given slowly by vein, and x-ray films are taken of the region of the gallbladder. Operative and postoperative cholangiography use the injection of contrast material into the common bile duct via a drainage T-tube inserted during surgery to reveal any small, residual gallstones that are present. In percutaneous transhepatic cholangiography the contrast material is injected through a long needle or needle catheter, which is introduced directly through the skin into the substance of the liver. Endoscopic retrograde cholangiography is accomplished by cannulating the ampulla of Vater through a flexible fiberoptic duodenoscope and instilling radiopaque material directly into the common bile duct.
interventions IV cholangiography cannot be used in the presence of severe liver disease or jaundice because the dye will not be concentrated and excreted into the bile. The patient fasts, and fluids are restricted overnight. An early morning cleansing enema is given, usually followed by a sedative. The patient is warned about a brief burning sensation that occurs as the dye is injected. For percutaneous transhepatic cholangiography, sedative premedication is often ordered and a local anesthetic injected at the site of needle puncture. Appropriate evaluation for bleeding tendencies must be carried out before percutaneous transhepatic cholangiography. Bile peritonitis is occasionally a complication of T-tube or percutaneous cholangiography, and close nursing observation is essential after the test is completed. For endoscopic retrograde cholangiography, nothing is given by mouth after midnight, an explanation is given to the patient, dentures are removed, and, to permit administration of medications, IV infusion is begun. The endoscope is passed with the patient in the left lateral position; then the patient is turned to the prone position, the ampulla is cannulated, the dye is injected, and films are taken. Vital signs are observed and the patient is given a light meal 2 to 4 hours after the procedure.
outcome criteria The resulting cholangiograms from any of these procedures are examined for unobstructed outlining of the biliary system. Calculi may be noted as shadows within the opaque medium.
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Cholangiography

cholangiography

Imaging Oral, IV or percutaneous administration of radiocontrast excreted into the bile tract, to detect gallstones or visualize bile ducts. See Percutaneous transhepatic cholangiography.

chol·an·gi·og·ra·phy

(kō-lan'jē-og'ră-fē)
Radiographic examination of the bile ducts using a contrast medium.
[chol- + G. angeion, vessel, + graphō, to write]

cholangiography

X-ray or other imaging examination of the bile ducts, usually after a fluid substance opaque to radiation has been introduced. The main object of cholangiography is to show stones in the bile ducts and gall bladder. The method may be done by direct injection through the skin into the liver (percutaneous, transhepatic cholangiography) or, by way of a flexible endoscope, through the bile duct opening in the duodenum (endoscopic retrograde cholangiography).

Cholangiography

Radiographic examination of the bile ducts after injection with a special dye.

cholangiography

x-ray examination of the bile ducts, using a radiopaque dye given intravenously or orally, as contrast medium. Little used in veterinary medicine.