Thin needle cholangiography as the primary method for the evaluation of the biliary-enteric anastomosis.

Twelve patients with biliary-enteric anastomoses were examined with transhepatic cholangiography to evaluate the etiology of epigastric pain, cholangitis, abnormal liver function tests, pancreatitis, or transient or persistent jaundice. Cholangiography was successful in all, and there were no significant complications. Four patients had reflux barium studies and one underwent endoscopic retrograde cholangiopancreatography. All five of these examinations failed to reveal diagnostic information relevant to patient management. Transhepatic cholangiography is easy to perform and relatively safe, especially in patients with unobstructed duct systems. In demonstrates biliary anatomy in great detail and can be used effectively regardless of the site of the anastomosis or prior gastric surgery. It is concluded that transhepatic cholangiography should be used as the primary means of evaluating the biliary-enteric anastomosis.