[Contact cholangiography in the pathology of the terminal choledochus]

We performed 25 operative contact cholangiographies in patients operated upon for biliary and/or pancreatic diseases. With this technic we obtained better operative radiologic studies of the distal portion of the common bile duct and of the proximal segment of duct of Wirsung; these images were sharper than that of the conventional operative cholangiography, giving a better idea of the real size of both biliary and pancreatic ductal size. The technic is performed placing a small dental occlusal X-ray plates that measures 5 x 7 cm behind the mobilized second portion of the duodenum and head of the pancreas by a Kocher maneuver and iodized contrast medium is injected through the cystic duct; we performed first a conventional operative cholangiography followed by contact cholangiography. In this series of patients we compared the results obtained with both types of cholangiographies, concluding that when there are doubts in the interpretation or in the diagnosis of the biliary condition at the distal portion of the common bile duct or at the ampullary region in a conventional operative cholangiography, it should be performed a contact cholangiography since this will yield better and sharper images.