title: New transhepatic biliary drainage procedures for safe intubation and early extubation.
abstract: OBJECTIVE
  The conventional transhepatic biliary drainage method requires a long period of tube placement and a technically difficult intubation.
  
  
  METHODS
  New transhepatic biliary drainage methods were applied in cases undergoing an open choledochotomy. The drainage tube was placed transhepatically using a newly developed, rigid and J-shaped needle (J-Needle) with a vertical, ventral and rotating penetration at the proximal hepatic duct. The tube was then introduced directly to the extraperitoneal space by attaching the parietal peritoneum to the liver surface without tube-fixation (extraperitoneal transhepatic tube method).
  
  
  RESULTS
  These procedures were applied in 50 patients. The J-Needle was easily and safely inserted without any complications. In the 39 analyzed cases, the patients were safely extubated on postoperative day 7 and discharged around postoperative day 10.
  
  
  CONCLUSIONS
  The combination of the J-Needle and the extraperitoneal transhepatic tube method is useful for safe transhepatic biliary intubation and early extubation, enabling a shorter hospital stay for patients requiring biliary surgery.
authors.affiliation: Department of Surgery, Hiratsuka City Hospital, Kanagawa, Japan. kaitosh@mb.scn-net.ne.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Kanai
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Takabayashi
authors.forename: Motohito
authors.initials: M
authors.lastname: Nakagawa
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Saikawa
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kawano
authors.forename: Michio
authors.initials: M
authors.lastname: Sakata
authors.forename: Naoto
authors.initials: N
authors.lastname: Miyazawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001662:Biliary Tract Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D003135:Common Bile Duct / Q000601:surgery*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D009339:Needles; D013536:Suture Techniques