Obscured common bile duct, Localization of biliary duct, Operative ultrasound
At times, structural abnormalities due to marked inflammation, tumor or previous operation obscure the location of common bile duct during operation, and impede the performance of operative cholangiography. We present two cases in which the biliary ducts were anatomically obscured by severe inflammation and dense adhesion caused by prior operation and biliary cancer. Operative ultrasound was employed, which successfully localized the common bile duct, detected common duct calculi, and guided a needle in the duct for operative cholangiography. Operative imaging ultrasonography is a safe, quick and reliable technique for locating and evaluating biliary ducts hidden by adhesions or diseases.