[Diagnostic procedures in congenital dilatation of the bile ducts (author's transl)]

A report is given of 29 cases with congenital dilatation of the bile ducts, and the value of different diagnostic procedures is discussed. Histology in combinations with clinical symptoms allows the diagnosis in cases with microhamartoma or with congenital fibrosis of the liver. Sonography is the most important procedure in the diagnosis of cysts of the liver (solitary cysts or polycystic conditions); it may be complemented by peritoneoscopy if diagnosis cannot be established with certainty by echogramm. If segmental dilatation of intrahepatic bile ducts (Caroli's disease) is suspected, intravenous cholangiography ought to be the first diagnostic step. A more reliable diagnostic procedure is endoscopic retrograde cholangiography (ERC) in theses cases; if ERC does not help, percutaneous transjugular cholangiography may be indicated. In establishing the diagnosis of cysts of the choledochus and of intra- plus extrahepatic dilatations of the bile duct systems sonography ought to be used in the first place; the method of choice in these latter conditions however is the ERC.