抄録
Ultrasound (US) -guided needle puncture is essential both for vascular and non-vascular intervention. We must be sensitive to technological advances of US such as fusion imaging with CT or MRI and needle enhancement processing. We need to understand tips of US-guided needle puncture. It is important to understand how to align the puncture needle precisely with the planned needle guideline. In addition, it is important to know how to correct the direction of the needle in case it deviates from the planned US guideline. By shifting the US probe and the needle just on the surface of the skin, the direction of the needle can be intentionally tilted and easily adjusted. In this manner, precise puncture can be easily achieved.
When PTBD of a non-dilated bile duct is necessary for patients with biliary complication after hepatobiliary surgery or liver transplantation, puncture along the longitudinal direction of the peripheral bile duct is useful. In cases with non-identified bile duct, parallel puncture or rendezvous technique using a microcatheter or a microguidewire inserted from another access is also helpful.
