INTERPRETATION OF THE INTRAVENOUS CHOLANGIOGRAM

• Sodium iodipamide injected intravenously was used in 300 cases in order to obtain serial cholongiograms. The results were studied in an effort to determine the various degrees of dilatation of the common bile duct, to relate them to preoperative and postoperative pain, and to establish criteria for preoperative diagnosis.Neither the sulfobromophthalein retention test nor the serum bilirubin concentration afforded a basis for predicting whether the duct would be made visible by the sodium iodipamide. However, visualization never occurred when the serum bilirubin level was above 4.8 mg. or when the sulfobromophthalein retention was above 64%.In 142 patients the bile passages were successfully visualized after cholecystectomy, so that the diameter of the common duct could be measured. These data were compared with the results of actually exploring the duct for obstructions. All ducts dilated to a diameter greater than 15 mm. were found to be partially obstructed, and all those narrower than 8 mm. were unobstructed. The 82 ducts of intermediate diameter (57% of the visualized cases) thus formed an important group in which the diameter of the duct was of no value in telling whether it was obstructed.Sodium iodipamide intravenously visualized the gallbladder in 12 out of 34 patients in whom visualization when the medium was given orally had succeeded poorly or not at all.