title: Access for percutaneous transhepatic cholangioscopy in patients with nondilated bile ducts using nasobiliary catheter cholangiography and oblique fluoroscopy.
abstract: 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.
authors: Department of Gastroenterology, Jichi Medical School, Yakushiji, Tochigi, Japan. tamadaki@jichi.ac.jp
authors: K
authors: K
authors: Tamada
authors: T
authors: T
authors: Tomiyama
authors: A
authors: A
authors: Ohashi
authors: S
authors: S
authors: Wada
authors: T
authors: T
authors: Miyata
authors: Y
authors: Y
authors: Satoh
authors: T
authors: T
authors: Higashizawa
authors: Y
authors: Y
authors: Gotoh
authors: K
authors: K
authors: Ido
authors: K
authors: K
authors: Sugano
mesh_terms: 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