ASSESSMENT OF THE BILIARY-TRACT BY ANTEGRADE CHOLECYSTOGRAPHY AFTER PERCUTANEOUS CHOLECYSTOSTOMY IN PATIENTS WITH ACUTE CHOLECYSTITIS

The diagnostic value of formal antegrade cholecystography in a consecu tive series of 44 patients with scintigraphically confirmed acute chol ecystitis, treated by percutaneous transperitoneal cholecystostomy, ha s been evaluated. A total of six patients did not have antegrade chole cystography (catheter migration in five patients and gangrenous gallbl adder perforation in one). Antegrade cholecystography was performed in the remaining 38: 10 patients with persisting cystic duct obstruction and 28 patients with patent cystic ducts. In the persisting cystic du ct obstruction group, antegrade cholecystography confirmed the cause o f gallbladder outflow obstruction as impacted calculi in either the ga llbladder neck or cystic duct in all patients. In the patent cystic du ct group, antegrade cholecystography demonstrated the common ducts wel l in all but two patients, and common duct calculi in eight of nine pa tients. Three patients had common duct calculi in non-dilated ducts. A ntegrade cholecystography is an easy and safe method of clarifying gal lbladder pathology in all patients, and can be used to evaluate the co mmon duct for associated common duct calculi in most patients.