Current role of intravenous cholangiography

One hundred consecutive intravenous cholangiograms were reviewed. In terms of bile duct and gallbladder visualization, 20 were of excellent quality, 40 were of adequate quality, and 40 were of poor quality or did not visualize. In retrospect, 12 of the studies were originally misinterpreted. Among the 29 patients who were eventually proven to have biliary tract disease, intravenous cholangiography was helpful in making the diagnosis in only 17 (59 percent). In 20 patients the study was performed to establish or rule out a diagnosis of acute cholecystitis; the test was helpful in only 9 (45 percent). It is concluded that intravenous cholangiography frequently results in marginal visualization that is subject to interpretive error. With the current variety of available tests that are able to visualize the biliary tree with a high degree of resolution, intravenous cholangiography has become a diagnostic anachronism.