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2 Folia Morphologica

2 2004

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The use of modern techniques of biliary tract monitoring in percutaneous drainage

100%

Ciesielczyk B. , Nowik M.

2004

tom 63

nr 3

The aim of this work is to assess the usefulness of current imaging techniques of biliary tracts in percutaneous transhepatic biliary drainage (PTBD). In the period from January 1996 to March 2003 44 cases of PTBD were carried out under ultrasonographic and X-ray control in 34 patients who could not have a bypass or endoscopic prothesis of the bile duct. The effectiveness of the method was evaluated in relation to the extent of the intra-hepatic bile ducts, the usefulness of simultaneous monitoring (ultrasonography and X-ray) and the possibility of preoperative contrasting of the bile ducts. Correct drainage of bile ducts was achieved in 43 PTBD. In 6 cases branches of the portal vein were pierced during drainage, but thanks to X-ray visualisation this was detected and the bile ducts were then drained correctly. During 4 PTBD the grooved probe slipped from bile ducts while the catheter was being introduced and a repeated prick was necessary. Total cholestasis caused by a tumour does not always bring about extension of bile ducts. However, simultaneous ultrasonographic and X-ray imaging of the bile ducts enables PTBD to be performed even in patients with a slight extension of the duct.

Intraoperative monitoring of the biliary tracts as a means of preventing choledocholithiasis oversight

100%

Ciesielczyk B. , Nowik M.

2004

tom 63

nr 3

The aim of the work is to assess the performance and effectiveness of intraoperative cholangiography or choledochoscopy in the prevention of choledocholithiasis oversight. The effectiveness of choledochoscopy was assessed in 50 patients during the years 2001–2002. Since 2000 intraoperative cholangiography has been performed on all patients after classic cholecystostomy in the absence of indications to choledochotomy. The effectiveness of intraoperative cholangiography was assessed in 50 patients in 2001. Both groups underwent ultrasonographic control and tests of biochemical parameters a year after surgery. The advisability of performing intraoperative cholangiography or choledochoscopy and their high degree of effectiveness in the prevention of choledocholithiasis oversight was confirmed.