Operative Cholangiography

Abstract

HomeRadiologyVol. 65, No. 2 PreviousNext Announcements and Book ReviewsBook ReviewsOperative CholangiographyPublished Online:Aug 1 1955https://doi.org/10.1148/65.2.287MoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractTechnik, Diagnostic Praxis. By Priv.-Doz. Dr. Walter Hess, Oberarzt der Chirurg. Univ.-Klinik Basel, with a Foreword by Prof. Dr. R. Nissen, Direktor der Chirurg. Univ.-Klinik Basel. A volume of 202 pages, with 150 illustrations. Published by Georg Thieme Verlag, Stuttgart Distributed in the United States and Canada by the Intercontinental Medical Book Corporation, New York, N.Y., 1955. Price DM 42,—($10.00). It is the intention of the author to acquaint the German-speaking medical world, through this book, with the benefits of routine operative cholangiography. According to him, the United States, Germany, and Switzerland have been particularly slow in accepting this procedure. The reason for the delayed recognition of the method in these countries lies in faulty technic. The mere taking of radio-graphs is insufficient for an adequate diagnosis. It must be combined with manometric readings according to the method of Caroli or that of Mallet-Guy developed in France in 1941 and 1942.Manometric readings thus form the main topic of the book, while roentgenographic interpretation is treated as a matter of secondary importance except in those cases in which residual stones, strictures, or tumors are a diagnostic problem. These cases are, however, a minority of the author's material, which comprises 261 essentially consecutive operations performed between 1950 and 1954, including 620 radiographs. The contrast medium used was Joduron (related to Diodrast) diluted to 20 per cent in order to prevent false pressure readings from spasm of ducts or sphincters.A variety of conditions was diagnosed with the help of operative radiomanometric cholangiography. Their recognition on the operating table is essential if one desires to reduce the incidence of the so-called postcholecystectomy syndrome. This syndrome is said to occur in 15 to 30 per cent of all cholecystectomized patients reported by others and is caused usually by conditions which were overlooked at operation but could have been remedied had adequate cholangiography been employed. Of the author's own series, 8.7 per cent suffered from persistent postoperative colic, while 30 per cent of his cholecystectomized patients, though freed of their colic, continued to have digestive complaints. Only 43.5 per cent were entirely symptom-free and only 31.8 per cent were able to live comfortably without dietary restriction. Fifteen patients (8.7 per cent of 170 adequately followed) required reoperation. Fourteen of these were again subjected to operative radiomanometric cholangiography, which was successful in all. Except in 1 case, the second operation produced a complete disappearance of symptoms. In this group, only 4 patients were found to have harbored residual stones. The cause of the post-cholecystectomy syndrome lies evidently elsewhere in the majority of cases.Article HistoryPublished in print: Aug 1955 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 65, No. 2 Metrics Altmetric Score PDF download