Operative cholangiography by direct puncture of the common bile duct

Direct common bile duct puncture offers an alternative to cystic duct cannulation in performance of operative cholangiography. Materials are readily available; no unusual cannulas or clamps are needed. The technique is easily mastered and consistently successful. Multiple roentgenograms, including one obtained after aspiration of dye from the duct, are of great advantage in detecting small stones. Careful application of puncture of the common bile duct does not add to morbidity nor does it prolong the recovery period.