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T管造影-彭泽
T-tube cholangiography(Postoperative T-tube cholangiography) 2011-12-1 pengze What When Why ? A T-tube cholangiogram is a type of biliary tract radiographic examination in which a water-soluble iodinated contrast medium is injected into the bile duct through an indwelling, T-shaped rubber tube. The tube is inserted in the common bile duct as a routine postoperative procedure to provide drainage. What When Why ? The occasion ot have a T-tube cholangiogram is 2 weeks after operation, at the mean time the symptom is relieved. The purpose is to make sure whether there is are residual gall stones within the biliary tree. 3-5 days 6 weeks Announcements ——Adverse reactions ↓ 1. Allergyic reaction —— contrast or iodine 2. Inflammatory reaction The interval between operation and cholangiography intraductal pressures, cholangiovenous reflux high viscosity of contrast Spasm of Oddis’ sphincter Announcements ——The detection rate ↑ 1. the viscosity of contrast 2. the differentiation of bubble 3. the range of developed bile tract Preparation and Procedure consent form—— contrast or iodine allergy ↓ 1)Meglumine Adipiodone Injection 2)Compound Meglumine Diatrizoate Injection 3)Iohexol Injection ★对策: 1)询问既往 2)碘过敏试验 3)之前注射皮质醇/抗组胺药 ★造影剂选择: 1)非离子型(低渗) 2)浓度15%-20%(泛影葡胺) 3)可混入抗生素(甲硝唑)? 4)温度 ★禁忌: 碘过敏、孕妇、甲状腺疾病等 Preparation and Procedure 2. no diet restrictions (Nothing to eat or drink for 4 hours prior to the test.) 3. The patient is positioned supine on the X-ray table. A slightly RPO position can help to ensure the CBD is not superimposed over the patients spine. A preliminary/scout image of the RUQ should be acquired. ↑ Preparation and Procedure 4.The tip of the T-tube is cleaned with antiseptic. ↓ 5.The T-tube should be raised and tapped to ensure there are no air bubbles lurking in the tube. ↑ 6.A butterfly needle should be inserted into the T-tube. The syringe plunger is withdrawn to remove bile from within the duct. (opt
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