In our experience, the ultrasonic examination should be the procedure of choice in the initial investigation of the patient with jaundice. It is independent from liver function and a noninvasive test which can be performed rapidly; in addition, the cause of extrahepatic obstruction can often be determined preoperatively. In our study, in many patients, the rose bengal scintigram has been indeterminate and has not been helpful in predicting whether obstructive or nonobstructive jaundice exists. Rose bengal scintigraphy appears to be of most help only in those patients in whom an adequate sonographic examination cannot be performed. Newer imaging agents currently being developed may prove to be more satisfactory in the future.
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