Abstract
A 69-year-old woman with choledocholithiasis was subjected to percutaneous transhepatic cholangiodrainage (PTCD) into the left intrahepatic bile duct (B3). A guide wire was advanced through the channel of the cholangioscope into the right intrahepatic bile duct (B6) as much peripherad as possible. A 14 Fr percutaneous transhepatic cholangioscope (PTCS) catheter was advanced over the guide wire into the B6 and the wire was removed. Microwave coaxial cable was pushed into the PTCS catheter into the B6 followed by coagulation of the ductal wall and liver tissue to prevent an unexpected bleeding. Next, the rigid portion of the guide wire was put into the PTCS catheter, penetrating the bile duct and liver capsule, into the abdominal cavity, retrogradely. A clamp inserted into the minute incised wound nearest to the wire tip grasped and pull it out. The 12 Fr PTCS catheter was advanced over the guide wire from the counter side (B6).
No adverse effects were obtained for the patient. We named the method PTRBD. PTRBD was very available for cloudy field by crushed fragments and intraductal decompression.
