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1 From the Department of Radiology, St. Luke's Hospital, New York, New York
The radiologist has proven percutaneous transhepatic cholangiography to be a safe, valuable diagnostic method. In the very ill patient much information can be obtined with relatively little trauma or discomfort. The biliary tree and common duct can be normal with good flow of contrast material into the duodenum. In patients with marked obstruction, the point of block and the probable etiology can be demonstrated. Surgery can be planned with reliable, advanced knowledge of the pathologic anatomy to be encountered and dealt with. Anatomy that is often obscured at the operating table by overwhelming tumor or diffuse fibrosis is clearly demonstrated on the cholangiogram.
The prognosis of persistent, progressive, severe jaundice is poor regardless of the etiology. For patients in whom extrahepatic block is even slightly suspected, percutaneous transhepatic cholangiography is strongly recommended as a safe, rapid and reliable source of information regarding the pathologic anatomy present.
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