DIE ROLLE DER I.V. CHOLANGIOGRAPHIE UND DER SONOGRAPHIE IN DER PRAOPERATIVEN DIAGNOSTIK VOR LAPAROSKOPISCHER CHOLEZYSTEKTOMIE

In a prospective clinical study the relevance of iv cholangiography and ultrasonography for preoperative diagnosis before laparoscopic cholecystectomy was assessed. Imaging of the common bile duct was realized successfully via iv cholangiography in 96.3% of all patients. Compared with ERCP, iv cholangiography diagnosis proved correct in 91.6% of all cases with pathological depiction of the common bile duct. Ultrasonography offered a sensitivity of 97.8% for assessing the common bile duct diameter. However, the distinction between intraductal concrements and artifacts caused by air superposition may be difficult. Iv cholangiography is the most sensitive and easy to realize diagnostic technique to identify concrements in the common bile duct. The results of this study indicate that a combined strategy of iv cholangiography and ultrasonography may replace ERCP for preoperative diagnosis before laparoscopic cholecystectomy, if there is a sufficient depiction of the common bile duct and without concrements in it.