Abstract
Many authors reported that visualization of cholangiogram was more difficult than that of pancreatogram in EPCG. and also emphasized that the failure of the contrast medium to enter the common bile duct in these cases may be due to organic stenosis or technical reasons. In our series, cholangiograms were obtained in 12 (42.8%) out of 28 cases such as papillitis without stones (8 cases), cholelithiasis ( 7 cases) choledocholithiasis (9 cases) and postcholecystectomy Syndrome (4 cases), which satisfy the major criteria (1-4) but in 18 (75.0 %) out of 24 other cases of cholelithiasis, choledocholithiasis, chronic pancreatitis and postcholecystectomy syndrome which did not have major criteria. In 7 out of eighteen cases where the canulation was succesf ul, the contrast medium did not enter the common bile duct on the first atemput, but entered the common bile duct after the intra venous administration of anti-cholinergic agents or anti catechol-o-metyl transf erase. We consider that the diagnosis of functional stenosis in terminal portion of the common bile duct be made in cases where opacification was only succesful after administering anti-cholinergic agents or anti COMT.
