A diagnostic evaluation of the endoscopic retrograde cholangiography in gallstone disease

Abstract

We have attempted endoscopic retrograde cholangiography (ERC) in 484 patients with gallstone disease, and in this paper referred to some problems about the characteristics of the shadows and differential diagnosis.
In all those patients with gallstone, ERC was succeeded in 85.3%(415 out of 484 cases). Opacified areas in 414 patients without a history of cholecystectomy were as follows, all biliary system distinctly in 49.3%, novisualization of the gallbladder and cystic duct in 11.1%, obstruction of the cystic duct in 18.6%, obstruction of the bile duct in 5.1% and the failure of the ERC in 15.9%.
The frequency of visualization of the gallbladder with stones in the cystic duct or gallbladder was 57.7% atmost.
It was impossible to distinguish from malignant diseases in some patients whose choledochograms showed saw or convex like obstruction or stricture with irregular surface of the bile duct.
Misdiagnosed cases which were proven by the operation have been experienced in 22 cases: disappearance of gallstone, cholecystitis, mucus or blood, aplasia of the gallbladder, foreign body in bile duct and so forth.