OPERATIVE or immediate cholangiography may be of great assistance to the surgeon who is dealing with a jaundiced patient. The cholangiogram may be of direct assistance by demonstrating the exact location and character of an obstruction. It may be equally useful in showing a completely normal extrahepatic bile duct system and thus help the surgeon prove that the jaundice is of hepatic origin.
A number of techniques for obtaining satisfactory operative cholangiograms are available, and each surgeon is likely to develop his own variations of the basic pattern. Of fundamental importance is close teamwork between the surgeon, roentgenologist, and anesthetist, and each of these must be aware of the problems of the other two. The equipment itself may be very simple. The x-rays used to illustrate this report were made with a standard portable x-ray unit, a Bucky frame, and a standard operating table. Before the operation the Bucky frame