Abstract
Percutaneous transhepatic cholangiography is an important diagnostic method for the differential diagnosis of the obstructive jaundice. This technique can be applied to percutaneous transhepatic cholangiodrainage (PTC-D), which decreases jaundice safely and successfuly. We have performed PTC-D in 62 cases with severe obstructive jaundice and the results were satisfactory. Recently, we have experienced percutaneous transhepatic cholangioscopy and cholangiobiopsy through the draining tube for the purpose of the new approach to accurate diagnosis for the biliary diseases. We used Machida's fiberbronchoscope (FBS 2.5) and Olimpus' kidney'fiberscope (K. F.). These were 2.5mm in diameter and have an angledeflector, but without washing and suction devices and biopsy channel. Using these small caliber fiberscopes, we could performed percutaneous transhepatic cholangioscopy through the draining tube in 8 cases with severe obstructive jaundice. Of these 8 cases, we could observe tumorous changes in 4 cases, but the other 4 cases we could not gain clear observation. As these fiberscope have no forceps-channel, after cholangioscopy we have introduced forceps through the draining tube under fluoroscopic control. In this way, we have performed percutaneous cholangiobio psy in 7 cases, among which we have got the tumors tissues in 2 cases. As complications, we have experienced slight bleeding from the bile duct in some cases, but no severe ones such as intraabdominal bleeding or bile peritonitis. We also discussed percutaneous transhepatic cholangioscopy and cholangiobiopsy, which were made possible during the application of PTC-D. More accurate diagnosis could be accomplished if these techniques would be applied. Improvement of the fiberscope itself would be also beneficial.
