The analysis of limiting factors on the visualization of the drip infusion cholangiography

Abstract

Four methods of Drip Infusion Cholangiography (DIC) method A, B, C, D were performed in patients with hepatobiliary diseases. Method A was basically a screening method, and the gallbladder was visualized in 68.8% and the common bile duct in 85.0% of 460 cases. Through method BD the gallbladder was visualized in 54.7% of 80 cases with suspected gallstone and the common bile duct in 78.8%. Through method C the visualization of the gallbladder was in 72.2% of 54 cases with parenchymal liver disorders and the common bile duct was in 50.0%.
The visualization rate of the gallbladder elevated from 32.3% to 58.1% and of the common bile duct 69.4% to 85.5% through method BD in addition to method A in 62 cases. Through method C in addition to method A the visualization rate of the gallbladder and the common bile duct elevated from 11.1% to 66.7% and 22.2% to 55.6% in 9 cases, respectively.
Through method A the visualization rate of the gallbladder significantly decreased in patients indicated over 20 KA unit of ALP, over 300 unit of LAP, over 300 unit of γ-GTP and over 3.0mg/100ml of serum total bilirubin, and the visualization rate of the common bile duct decreased in patients indicated under 0.100 of KICG, under 0.1000 of a_ICG and over 20.0% of R_15ICG Through method BD the visualization rate of the gallbladder and the common bile duct was paralleled by changes in the degree of liver function tests. Through method C the visualization rate of the gallbladder decreased in patients indicated over 3.0mg/100ml of serum total bilirubin, under 0.050 of K_ICG, and over 40.0% of R_15ICG.
The optimum time to visualize the gallbladder in the patients with normal ICG test was 90 minutes after the drip infusion, whereas that of the common bile duct was 30 minutes. In the patients indicated under 0.100 of KICG or above 20.0% of R_15ICG the gallbladder was favourably visualized at 120 minutes and the common bile duct was at 60 minutes.
From these results it was concluded that the visualization of gallbladder was influenced by the excretory factors of iodipamide from liver to bile and that of the common bile duct was influenced by the uptake factors from plasma to liver, and that the specific method to be used should be determined by analysis of the liver function tests.