[Critical evaluation of non-biological complementary examinations of the biliary tract before deciding on therapy...

A critical evaluation of non-biological complementary examinations of the biliary tract was conducted to assess their value when deciding on therapy. The published literature was reviewed, and the sensitivity and specificity of the different methods presented, emphasis being placed on the primary investigations of ultrasonography and oral and intravenous biligraphy. Secondary exploratory procedures (transparietal cholangiography, retrograde endoscopy with cholangiography and pancreatography, scintigraphy, gallbladder infusion parietography, scanography, and arteriography) are defined and their value discussed. Published data suggest that ultrasonography should be the initial investigation, this often being sufficient to enable suitable therapy to be chosen. Only approximately 5 p. cent of patients are unable to benefit from gallbladder exploration, and these require conventional radiological examinations before deciding on therapy.