title: Internalization of a second transhepatic biliary access with a captured microwire forced-buckle maneuver: description, anatomic applications, and results.
abstract: Percutaneous biliary drains are classified into external and internal/external drains. Internal/external drains can drain bile externally and internally (ie, anatomically) into bowel. Internal drainage is usually desired because it is associated with less morbidity. Not infrequently, operators encounter a situation in which one of two transhepatic biliary access tracts has been successfully internalized, and a second access cannot be internalized. The present report describes a technique that internalizes a second percutaneous transhepatic biliary access-relying on an initially successful first internalization-by capturing a microwire from the externalized to the internalized tract and forcing it down into the bowel. The anatomic applications and results of this technique are described.
authors.affiliation: Department of Radiology, University of Virginia Health System, 1215 Lee St., P.O. Box 800170, Charlottesville, VA 22908, USA. wspikes@yahoo.com
authors.forename: Wael E A
authors.initials: WE
authors.lastname: Saad
mesh_terms: D000328:Adult; D000368:Aged; D057785:Catheters; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D004322:Drainage / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome