Double-catheter method to prevent dislodgement during percutaneous transhepatic cholangioscopy.
BACKGROUND
We evaluated the utility of the double-catheter method to establish the track for percutaneous transhepatic cholangioscopy (PTCS).


METHODS
Dilatation of the percutaneous transhepatic track to 16F for PTCS was attempted in 105 patients. The results were prospectively analyzed. Using the single-catheter method (n = 22), a 16F PTCS catheter was replaced without the inner catheter. Using the double-catheter method (n = 83), a 7F catheter with a balloon tip was inserted through a 16F PTCS catheter. The balloon was located distal to the major duodenal papilla. The double-catheter method was further subclassified as follows: Method 2A (n = 62), the tip of the outer catheter (16F) was not advanced through biliary stenoses; Method 2B (n = 21), the catheter was advanced through biliary stenoses.


RESULTS
In the patients treated by the double-catheter method, dislodgement of the catheter did not occur, whereas the single-catheter became dislodged in 18% (p < 0.0005). The morbidity of method 2A (0%) was less than that of method 2B (14%) (p < 0.005).


CONCLUSIONS
The double-catheter method prevents dislodgement of the PTCS catheter. The outer catheter should not be advanced to the biliary stenosis.
Department of Gastroenterology, Jichi Medical School, Yakushiji, Tochigi, Japan.
K
K
Tamada
A
A
Ohashi
T
T
Tomiyama
T
T
Miyata
S
S
Wada
Y
Y
Satoh
K
K
Ido
K
K
Sugano
D000328:Adult; D000368:Aged; D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000628:therapy*; D002404:Catheterization; D004106:Dilatation / Q000295:instrumentation / Q000379:methods; D016145:Endoscopy, Digestive System / Q000295:instrumentation / Q000379:methods*; D004869:Equipment Safety; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity