If residual biliary stones are suspected during a cholecystectomy, which radiologic examination should be performed later?

• A. Ultrasound
• B. X-ray
• C. Postoperative/T tube cholangiogram
• D. CT scan

Answer: (C)

When residual biliary stones are suspected during a cholecystectomy, a postoperative T-tube cholangiogram is the most appropriate radiologic examination to confirm the presence of any remaining stones in the bile duct. This procedure allows for direct visualization of the biliary tree after the placement of a T-tube, which drains bile from the liver and can also be used to inject contrast material. By doing this, the surgeon can assess for any obstructions or stones that may not have been removed during the initial surgery.

The T-tube cholangiogram is specifically designed for this purpose and provides clear imaging of the biliary system, which is crucial in determining whether further intervention is necessary. Other imaging techniques like ultrasound or CT may also be used, but they are generally less definitive in identifying and assessing biliary stones compared to a T-tube cholangiogram. Likewise, standard X-rays do not provide the necessary information regarding the biliary system after cholecystectomy. Therefore, the T-tube cholangiogram stands out as the preferred method for evaluating residual stones post-surgery.