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THE place of operative cholangiography is discussed. Of 134 patients undergoing routine cholecystectomy 24 had choledochotomy. In four patients stones were discovered unexpectedly by this X-ray technique. Nine patients did not have choledochotomy because their operative cholangiogram was normal yet without the help of cholangiography this would have been indicated. Routine operative cholangiography is thought to be an essential technique in modern biliary surgery. [ABSTRACT FROM AUTHOR]

Patients with biliary tract disease should be prepared for possible operation on the common bile duct. There is little increase in morbidity when the common bile duct is examined directly in patients with obstructive jaundice, cholelithiasis and its complications, suspected tumor and in the post-cholecystectomy syndrome. Improved results in patients with common bile duct disease have been due as much to preoperative diagnosis and management by the family physician and the non-procrastinating gastroenterologist as to improved knowledge and surgical skill. [ABSTRACT FROM AUTHOR]

Newborn infants with jaundice are treated by the general practitioner or pediatrician and do not usually come within the province of the pediatric surgeon unless complications arise. In exceptional cases, jaundice may be prolonged and become obstructive in type. These are of special surgical interest, and may cause great difficulties in diagnosis and treatment. It may be of interest to review cases with prolonged neonatal jaundice seen during a ten-year period at Alder Hey Children's Hospital in Liverpool. The principal causes of the jaundice, in the study, proved to be hepatitis and biliary tract atresia. There were also several cases of plugged extra-hepatic bile ducts, jaundice associated with pyloric stenosis, extrinsic obstruction of the bile ducts, spontaneous perforation of the bile ducts, and neoplasm.