Procedure (cont.)

Rotate the patient into a RPO position. After filling the intrahepatic and extrahepatic ducts well with the contrast agent, take a final image. Try to time the exposure for when contrast squirts from the common bile duct (CBD) into the duodenum.

If there is a question about whether filling defects in the bile ducts are air bubbles or stones, film the patient in the upright or semi-upright position, as bubble tend to rise and stones tend to gravitate into the distal CBD.
Leave the syringe connected to the t-tube until the images have been processed and reviewed and you are certain that you will not need additional duct filling and pictures.
When satisfied that the study is complete and diagnostic, reattach the bile bag to the t-tube and open the tube to drainage into the bag.