2000 Volume 61 Issue 4 Pages 858-861
We evaluated the indication and problems of percutaneous transhepatic cholangiographic drainage (PTCD) under ultrasonography-guided puncture using the 21G needle with catheter in order to decrease the X-ray radiation to the operator's hands. The catheter of the 21G needle is flexible and we can performed cholangiography and insert guide wires and drainage tubes from outside of X-ray field. By this reason this method of PTCD can decrease X-ray radiation to the hands.
These procedures of PTCD were performed in 214 times of 190 patients in our hospital. The punctures of the bile duct were successfully performed in all cases, but insertion of the drainage tube failed in 12 times because of insufficient dilatation under 5mm in diameter and hardness of the bile duct.
As a result it is considered that this method is indicated for dilatation of the bile duct over 5mm in diameter and that the suitable angle of puncture and selection of an appropriate catheter are important.
The complications in this series were bile duct bleeding in two cases, deviation of the catheter in four cases and serious shock in one case.
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association)
