Double-Dose Drip-Infusion Cholangiography

In routine, single-injection, intravenous cholangiography, incomplete or faint visualization of the biliary system is common. To overcome this deficiency, a drip infusion of a larger volume of iodipamide meglumine and tomography have been used. In a series of 107 cases, this method produced no instances of nonvisualization in patients with serum bilirubin levels below 3 mg/100 ml. As a rule, the duct system was densely opacified. Consequently, stones in the common duct could be directly seen as radiolucencies. In a series of 32 patients, correlation of roentgenographic interpretation and surgical findings was excellent. Diagnosis of obstructions within the common duct, therefore, did not have to be based on indirect signs as in the past. Reactions to the larger volume of contrast medium were minimal.