Abstract
Endoscopic retrograde cholangiography (ERC) was carried out for 104 patients who complained of epigastric pain or discomfort suggesting biliary diseases. ERC was succeeded in 77 patients (74.0%). Among the 77 patients, 49 were revealed to have biliary diseases by ERC. ERC was unsuccessful in 27 patients and main causes of failure were thought to be a dislocation of the duodenal papilla into a diverticulum and a state of postgastrectomy after Rillroth I operation. Operations for biliary diseases were performed in 43 patients, of whom 34 were with successful ERC and nine were with unsuccessful one. Among the operated patients, unsuccessful ERC frequently resulted when they had Lemmel's syndrome; unsuccessful in four out of six patients with the syndrome. Lemmel's syndrome could be diagnosed, even in cases of failed ERG, by an endoscopic confirmation of the duodenal papilla in a diverticlum and compatible symptoms. ERG was repeated twice in 12 patients, of whom five were successful on both occasions. ERG failed at the first trial in the other seven patients, but succeeded at the second trial in three. It is a matter of course that a repetition of the examination may result in a success. Dripping infusion cholangiography (DIG) was attempted prior to ERG for 52 patients and was contributory in 23. Operated patients were 39.1% of the group with a successful DIG, 41.4% of the one with unsuccessful DIG and 25.0% of that in which DIG was not attempted. DIG may play a role of screening test for determining indications of ERG.
