X-ray (cholecystocholangiography) of the gallbladder and bile ducts

Radiography of the gallbladder and bile ducts (cholecystocholangiography) is a modern method for diagnosing the pathology of the biliary system. The method is based on the visualization of the gallbladder and bile ducts using an X-ray machine after the introduction of a contrast agent.

What is X-ray for?

The contrast agent used to visualize the gallbladder and ducts, bilitrast, is iodine-containing. The scanning machine concentrates and directs x-rays, which pass through the soft tissues and the injected substance in different ways. A contrast agent is administered intravenously immediately before the procedure after a tolerance test.

From the blood, the contrast agent enters the liver, gallbladder and its ducts. The results of cholecystocholangiography are based on the pictures taken, which record the passage of a contrast agent. With their help, you can assess the degree of damage to the bladder and ducts, see tumors, calculi, as well as other formations and anomalies that are not visible during other research methods. Pictures are taken 20 minutes, 30 minutes and 40 minutes after the injection of contrast, for a phased assessment of the function of the entire biliary system.

Indications for the procedure

Cholecystocholangiography is prescribed to diagnose pathologies of the hepatobiliary system.

Contraindications to the procedure

The main contraindications to this contrast x-ray examination are intolerance to iodine-containing drugs, severe damage to the liver and kidneys.

Unless absolutely necessary, the procedure is not performed for pregnant women in the first trimester. For children, cholecystocholangiography is prescribed in cases where the benefits of the information obtained during the study outweigh the risks of exposure. During the study, additional protective aprons are used (protect the chest, thyroid gland and genitals).

Features of

During the study, additional pain or symptoms of malaise may be observed. Before prescribing the procedure, the attending physician assesses the risks and prescribes additional studies. Complications after cholecystocholangiography in rare cases can be:

• prolonged headaches;
• disorders in the work of the gastrointestinal tract;
• nausea and vomiting (symptoms of intoxication of the body).

Cholecystocholangiography is performed only in cases where standard research methods do not help to establish an accurate diagnosis (biochemical blood tests, ultrasound). The dose of X-ray exposure received during the study should be summed up with the total radiation load received during the year.

Also, cholecystocholangiography is performed before liver surgery, when it is necessary to assess the condition of the excretory ducts. This research method is a mandatory part of preoperative preparation. The results (images) display neoplasms that may become a contraindication to surgical intervention.

Preparation for radiography

Before the procedure, the patient is recommended to follow a diet with limited fiber for three days before the study to prevent gas formation. Cleansing enemas and choleretic breakfasts are not required before this study.

Procedure

A contrast agent is administered in two ways – orally or intravenously. In the second method, the substance is administered immediately before the procedure. After installing the catheter, the patient is placed on the table (pictures are taken standing and lying down). The health worker takes several pictures by changing the focus of the machine’s main scanner.

The procedure is carried out in two opposite positions. The patient needs to remain still while scanning and testing of focal images is carried out. After taking the yolks (an hour later), pictures of the emptied organ are taken. The pictures show the shadows of the bile ducts. If the liver is clearing the contrast agent, the gallbladder is visible on the images without interference. If the paths are obstructed, the contrast agent will begin to accumulate, which will appear on the obtained images.

After the procedure, the patient can eat and drink.

Modern cholecystocholangiography

Currently, percutaneous transhepatic cholangiography is used. A laparoscope is used to introduce an iodine-containing substance. In this study, contrast is injected directly into the bile ducts during a percutaneous liver puncture.

This method is suitable for examining the biliary tract for the presence of fistulas or neoplasms. The choice of method for introducing contrast depends on the area being examined. Cholecystocholangiography is performed in a special room protected from background radiation. Image fixation is performed by medical workers from a designated secure room, using protective aprons and plates.

Procedure results

Cholecystography is prescribed to study the anatomical structure and functional activity of the gallbladder and bile ducts. On the resulting image, it is possible to evaluate the shape and position of the area under study, the displacement of its position relative to the norm. The size of neoplasms and stones is estimated from several images taken in different planes. The XNUMXD image allows you to evaluate volumetric abnormal formations, tumors and polyps that interfere with the functioning of the gallbladder or ducts.

Cholecystocholangiography gives a clear picture of the internal organ: the gallbladder is pear-shaped with smooth outlines and a thin contour. Any deviations from the norm are recorded by the radiologist and are the reason for the appointment of additional research methods. The shape of the gallbladder may differ from the norm due to the design features of the body. In hypersthenics, the bladder has a round shape, and in asthenics it is elongated upwards: the structural features and position of the organ are assessed by the doctor who writes the conclusion on the cholecystocholangiography.

Image interpretation

The results obtained are the basis for further research or an accurate diagnosis. The attending physician is based on the conclusion of the radiologist, who describes the image obtained in detail (the specialist evaluates the degree of darkening of the organ and ducts, analyzes the smoothness of the surface and the volume of neoplasms). The picture shows a violation of the patency of the contrast fluid with obstruction by stones, scars or neoplasms. With the help of the resulting picture, a reduced concentration of the biliary tract is established.

The resulting image allows you to consider violations in the motor function of the efferent biliary tract. The patient does not independently prescribe cholecystocholangiography and decipher the obtained images.

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