Access for percutaneous transhepatic cholangioscopy in patients with nondilated bile ducts using nasobiliary catheter cholangiography and oblique fluoroscopy.
BACKGROUND
Percutaneous transhepatic biliary drainage is required for percutaneous transhepatic cholangioscopy. However, puncture of nondilated bile ducts under ultrasonographic guidance is difficult.


METHODS
In 10 patients with no ultrasonographic evidence of intrahepatic bile duct dilatation, percutaneous transhepatic biliary drainage was performed under fluoroscopic guidance using cholangiography obtained via a nasobiliary drainage catheter. Direct puncture was performed by means of a left ventral approach using oblique C-arm fluoroscopy.


RESULTS
Bile duct puncture was successful in all patients. There were no procedure-related complications. Subsequent cholangioscopy was successful in all patients.


CONCLUSIONS
Direct puncture using nasobiliary drainage cholangiography and oblique fluoroscopy is a useful method when cholangioscopy is necessary in patients with nondilated bile ducts.
Tamada
K
K
Department of Gastroenterology, Jichi Medical School, Yakushiji, Tochigi, Japan. tamadaki@jichi.ac.jp
Tomiyama
T
T
Ohashi
A
A
Wada
S
S
Miyata
T
T
Satoh
Y
Y
Higashizawa
T
T
Gotoh
Y
Y
Ido
K
K
Sugano
K
K
D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D001652:Bile Ducts / Q000473:pathology; D002404:Catheterization / Q000379:methods; D002758:Cholangiography / Q000379:methods*; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D016896:Treatment Outcome