Today our topic of discussion is Procedure of Cholangiography.
Procedure of Cholangiography
Procedure
- IV Cholangiography: A consent form for IV cholangiography should be signed.
- The client should be on NPO for 8 hours before the test.
- Some radiologist encourages fat-free liquids before the test to prevent renal toxicity caused by the injected dye
- A laxative (e.g. citrate of magnesium or castor oil) may be given the night before the test, and cleansing enema may be given in the morning.
- Keeping the gastrointestinal tract clear can prevent shadows in the X-ray films.
- Check with radiology department for the exact preparation needed.
- A contrast agent, iodipamide meglumine (cholografin) is injected intravenously while the client is lying on a tilting X-ray are taken every 15-30 minutes until the common bile duct is visualized.
Percutaneous Cholangiography
- A consent form for percutaneous cholangiography should be signed
- The client should be on NPO for 8 hours before the test
- A laxative the night before and cleansing enema the morning of the test may be ordered
- Preoperative medications usually include sedatives tranquilizers.
- An antibiotic may be ordered for 24-72 hours before the test for prophylactic purposes
- The client is placed on tiling table that rotates.
- The upper right quadrant of the abdomen is cleaned and draped
- A local (skin) anesthetic is given
- The client should exhale and hold his or her breath while a needle is inserted with the guidance of fluoroscopy into the biliary tree.
- Bile is withdrawn, and the contrast substance is then injected.
- Spot films are taken
- A sterile dressing is applied to the punctured site.
T-tube Cholangiography
- A consent form for T-tube cholangiography should signed
- The client should be on NPO for 8 hours before the test .
- A cleansing enema may be ordered in the morning before the test
- The client lies on an X-ray table, and a contrast agent such as sodium diatrizoate (hypaque) is injected into the T-tube and an X-ray is taken 15 minutes later
- The T-tube may be removed after the procedure or it may be left in place.
- Factors affecting diagnostic results: Obesity and gas or fecal material in the intestines can affect the clarity of the X-ray,
- Client education: Instruct the client to remain in bed for 6 hours following percutaneous cholangiography.