From Big Medical Encyclopedia

PANKREATOHOLANGIOGRAFIYA RETROGRADE (grech, pankreas, pankreatos a pancreas + chole bile + angeion a vessel, a bed + grapho to write, represent; lat. retrogradus moving back, the return; synonym endoscopic retrograde pankreatokholangiografiya) — a method of X-ray inspection of pancreat ducts and bilious ways by administration of contrast medium through fater of pacifiers of a duodenum. The item of river implemented in a wedge, practice in 1969 I. Oi. Its important advantage is the combination of an endoscopic research of a duodenum (see. Duodenoskopiya ) with rentgenol, studying of bilious ways and pancreat ducts.

the Retrograde pankreatokholangiografiya at cholelithiasis: the general bilious channel (1) is sharply expanded, in it defects of filling from three big stones are visible (are specified by shooters); the pancreat duct is expanded (2), has uneven contours.

On pankreatokholangiogramma it is possible to estimate passability of channels pancreas (see) and bilious ways (see. Bilious channels ), their provision, a form, existence of anomalies of development, concrements, and also the changes caused by inflammatory, tumoral and traumatic defeats (fig).

The main indications: diagnosis hron, pancreatitis and its complications, a pancreatic cancer, a postcholecystectomy syndrome, clarification of the reasons of a cholestasia and cholangitis in cases when the shadow of bilious ways does not come to light by means of intravenous holegrafiya (see), differential diagnosis of damages of bilious channels and pancreat ducts, assessment of function of a bi-liodigestivny anastomosis.

Contraindications: serious condition of the patient, acute inf. diseases, dysfunction of cardiovascular system, liver, kidneys, intolerance of iodine. By the item of river it is complicated at a pyloric stenosis, tumors in periampulyar-ache areas, after stomach and duodenum operations.

Technique. Items of river carry out in the X-ray department equipped with the X-ray television device. Via the biopsionny channel of a fibroduodenoskop enter the thin teflon probe with a cannula into a duodenum. After fixing of a cannula in an ampoule of a faterov of a nipple (a big nipple of a duodenum, T; papilla duodeni major) via the probe under X-ray television control enter 60% solution of a triyodirovanny contrast agent and make a X-ray analysis in different projections.

Complications. According to nek-ry researchers, the frequency of complications after P. of river makes apprx. 3%. The most frequent and dangerous complications of P. are acute pancreatitis and a septic cholangitis.

Bibliography: Blagovidov D. f., etc. Endoscopic pankreatokholangio-grafiya, Owls. medical, No. 3, page 36, 1976; In and-silyevyu. Century, etc. Retrograde punk reatokholangiografiya by means of cannulate of a faterov of a nipple via the duodeno-fiberscope, Klin, medical, t. 50, No. 7, page 36, 1972; Syomin M. D. Difficulties of a retrograde endoscopic pankreatokho-langiografiya, in the same place, t. 56, No. 6, page 95, 1978; And p and with k e r H., Weiss H. D. a. Kramann B. Endoscopic retrograde pancreaticocholangiography (ERPC), B., 1977; M a n e g o 1 d B. C., B o t t g e r E. u. R e n n e r M. Maligne Tumoren an den Gallenwegen, Fortschr. Rontgenstr., Bd 121, S. 767, 1974.

L. D. Lindenbraten.