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T-Tube Cholangiogram, MedPix™ : 4262 - Medical Image Database and Atlas
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More Like This ? T-Tube Cholangiogram
Topic ID: 4262 - Modified: 2002-10-24 17:20:08-04 - Created: 2002-10-19 14:23:42-04
ACR Index: 7.7

T-Tube Cholangiogram

Biliary calculi are the most common filling defects seen in the opacified bile duct. They usually arise in the gallbladder and reach the common bile duct either by passage through the cystic duct or by fistulous erosion through the wall of the gallbladder. Stones in the extra-hepatic bile ducts tend to move freely and change locations with alteration in patient position. A calculus can become impacted in the distal common duct and cause obstruction. The impacted stone can usually be diagnosed with confidence because of the characteristic appearance of a smooth, sharply defined meniscus.

T-Tube cholangiography is frequently performed in the operating room after cholecystectomy through a t-tube placed in the common duct. The main application is to identify any calculi missed by palpation during the procedure. It is also used post-operatively, prior to the removal of the T-tube. This is done by the Radiology department in the fluoroscopy suite to demonstrate the patency of the common duct, the absence of retained stones, and free passage of bile into the duodenum.

If stones are noted to be present when a T-tube cholangiogram is performed postoperatively then the radiologist notifies the surgeons about the findings. At our institution transduodenal papillotomy with extraction under endoscopic visualization (ERCP) is used to remove retained gall stones.

Topic Contributor Credits

Topic Submitted by: Matthew J Hoffman - Author Info
Affiliation: National Capital Consortium
Topic approved by: Perry J. Pickhardt, M.D. - Editor Info
Affiliation: National Capital Consortium

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