Although endoscopic retrograde cholangiopancreatography is the technique of choice for examining the biliary tract when ultrasonography does not demonstrate dilated ducts, the transhepatic cholangiopancreatogram was shown to be useful when endoscopic retrograde cholangiopancreatography fails. On cholangiography, ultrasonography, and CT,
clonorchiasis and
cryptosporidiosis were found to have duct dilatation and contour irregularity, and in some patients, papillary
stenosis. The value of cholangiography in determining the prognosis and appearance of
primary sclerosing cholangitis and in diagnosing
Klatskin tumor was examined. Patients with high-grade extrahepatic
strictures, diffuse intrahepatic
strictures, and marked intrahepatic dilatation had decreased survival. The preoperative cholangiogram diagnosis of
Klatskin tumor was found to be accurate in only two-thirds of cases. In patients with
liver transplantation who had dilatation of both donor and native extrahepatic bile ducts and abnormal liver function tests, but no evidence of anastomotic
stricture, malfunction of the sphincter of Oddi was suggested as a possible cause. The sonographic features of acute
gallbladder disease were evaluated and striations in the thickened gallbladder wall were shown not to be a specific sign for
acute cholecystitis. Also, the ultrasonographic diagnosis of early gallbladder
carcinoma was not accurate enough, but ultrasonography was reaching a sensitivity of 70% to 80% for advanced
gallbladder cancer.