Limited usefulness of carbon dioxide as a contrast agent for cholangiography

Abstract

Carbon dioxide (CO2) was unsuccessfully used as a biliary contrast agent in 9 of 10 patients undergoing percutaneous transhepatic cholangiography prior to biliary drainage. The technique involved hand injection of 10-20 cc CO2 through the Chiba needle in an attempt to fill preferentially the anterior biliary radicals. Although CO2 remains a useful agent in many instances, particularly for percutaneous nephrostomy, its usefulness in the biliary tract is severely limited.

Carbon dioxide‐enhanced virtual MDCT cholangiopancreatography

“…During this period, cholangitis and the patient's nutritional state are often adversely affected, with a poorer prognosis due to the delay in the initiation of treatment and surgery, often resulting in a reduction in patients' quality of life. The clinical application of CO 2 has been established in laparoscopic surgery, with some reports of intravascular [8,9] and intrabiliary [1,2] administration in clinical practice. As a gaseous contrast agent, its physicochemical properties have special requirements concerning the radiologists' knowledge, the X-ray equipment, the infuser and the catheters.…”

“…The clinical application of CO 2 has been established in laparoscopic surgery, with some reports of intravascular [8, 9] and intrabiliary [1, 2] administration in clinical practice. As a gaseous contrast agent, its physicochemical properties have special requirements concerning the radiologists' knowledge, the X‐ray equipment, the infuser and the catheters.…”

“…Carbon dioxide (CO 2 ) as a contrast agent in cholangiography has been developed as an alternative to iodinated contrast material to avoid these problems . Once the behavior of intraluminal CO 2 gas, the methods of safe delivery, and the principles of successful imaging are understood, the use of CO 2 as a contrast agent during cholangiopancreatography will allow accurate imaging with little risk.…”