(2) Delayed cholangiography. This examination usually follows the removal
of the gallbladder and is normally performed in the x-ray department. Following
surgery, a T-tube is left in place within the biliary tract for continuous drainage. Utilizing
the same type of contrast medium as for immediate cholangiography and eliminating
the need of anesthesia, the material is injected through the T-tube into the biliary tract
by the radiologist. The radiologist will also decide the type and the number of
radiographs to be made.
b. Intravenous Method.
(1) Usually, the patient does not eat or drink anything after 6 p.m. on the
day prior to the examination.
(2) On the morning of the examination, the patient is given a sensitivity test.
If there are no contraindications, the radiologist slowly injects intravenously 40 cc of
cholangiopaque (Cholografin).
(3) Ten minutes after the injection, the first film is made. Meanwhile,
observe the patient for any reaction.
(4) RPO radiographs are casually made to prevent superimposition of the
common bile duct over the spine. Body rotation is 15 to 20 degrees.
(5) The initial film is processed immediately and is read by the radiologist.
This film also provides the specialist a means of checking for the proper positioning of
the patient and the corrections of the exposure factors.
(6) Subsequent films are exposed at 10-minute intervals for the first hour
and at 20-minute intervals for the second hour. In each instance, the film is processed
immediately and read by the radiologist.
(7) Ordinarily, this completes the examination. However, under certain
conditions, tomographic variations of positioning may be used.
MD0959
2-40