Direct cholangiography

The role of direct cholangiographic methods has evolved significantly over the last two decades as other high-resolution imaging modalities have become available. Most of the time, careful clinical evaluation of a patient combined with ultrasonography or CT will enable a physician to arrive at a correct diagnosis with a high level of precision. In this article we have attempted to indicate situations in which direct cholangiographic methods are necessary to diagnose and treat certain hepatobiliary problems. Considerable controversy exists concerning the application of these methods for treatment of biliary problems. However, in circumstances in which the issues are openly discussed, application of these techniques can be agreed on. Direct cholangiography, like coronary angiography, is a technology that provides considerable valuable information that at present cannot be obtained by other techniques, and, in well-defined circumstances, is necessary for precise diagnosis and therapy.