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Relationship of biliary pressure to cholangiovenous reflux during endoscopic retrograde balloon catheter cholangiography

Relationship of biliary pressure to cholangiovenous reflux during endoscopic retrograde balloon catheter cholangiography

Digestive Diseases & Sciences 34(1): 16-20

In 32 patients undergoing endoscopic retrograde cholangiography with a balloon catheter, culture of bile, biliary pressure at maximal visualization of the biliary tract with iodinated contrast medium, serum iodine concentrations, and blood cultures before and after the procedure were obtained. There was a significant increase in the serum iodine concentration in five of nine patients (55.6%) with pressure between 22 cm H2O and 30 cm H2O and in nine of 13 patients (69.2%) with pressure above 30 cm H2O, whie it remained low in 10 patients with pressure below 22 cm H2O. Two patients showed positive blood culture after the procedure, which yielded the same organisms as found in the bile. The biliary pressure in these two patients were 30.4 cm H2O and 38.0 cm H2O. These data suggest that during retrograde balloon catheter cholangiography: (1) cholangiovenous reflux of contrast medium develops with biliary pressure higher than 22 cm H2O (2) the indicence of the cholagiovenous reflux increases as the pressure is elevated, and (3) regurgitation of bactria occurs with pressure greater than 30 cm H2O. These finding are noteworthy because the numbers of patients who need direct cholangiography is increasing.

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Accession: 007740061

Download citation: RISBibTeXText

PMID: 2910677

DOI: 10.1007/bf01536148

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