[Trans-Kehr postoperative cholangiography in upright and horizontal positions: the morphofunctional aspects of the biliary tract].
To change from the lying position to the upright position, in patients without their gallbladder, causes: a) a rapid and partial emptying of the biliary ducts towards the duodenum by the amplification of the opening phasic waves activity of the sphincter of Oddi (S. O.); b) an important reduction caliber of the main biliary duct (M. B. D) and c) stability of the intraductal pressure with slight raising in upright position. These physiological concepts allow a better cholangiographic exploration by means of a drip of 60 to 70 drops per minute of diluted tri-iodic in: 1) Upright position, which gives a good image regarding the terminal choledochus; of the biliary duodenal flow, and of the reduction of the caliber of the MBD. 2) In lying down position which allows: the filling up of the complete biliary-tree with possible scarcity of information about the distal choledochus-duct; the appreciation of the degree of the expansion of the MBD, and the measuring of the delay of the emptying out of the X-ray-opaque substance in relation to what was found in the upright position. The elasticity of the walls of the biliary ducts acts efficiently in the compliance of the container and contained. In normal choledochal ducts, the top level images in the upright position do not go beyond the hepatic duct. When there are problems with the flow through the S. O., there is a filling up of the intrahepatic biliary ducts with the contrast substance introduced in the upright position.
Departamento de Cirugía, Hospital General de la Ciudad Sanitaria Valle de Hebrón, Barcelona.
A
A
Díez-Cascón
V
V
Ayuso Osuna
E
E
Díez-Cascón Menéndez
J
J
Moreno Amezcua
D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002758:Cholangiography / Q000295:instrumentation / Q000379:methods*; D002763:Cholecystectomy; D002768:Choledochostomy; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care / Q000379:methods*; D011187:Posture
D003287:Contrast Media
La colangiografía postoperatoria trans Kehr en posiciones orto y horizontal: aspectos morfológico-funcionales de las vías biliares.