Double-catheter method to prevent dislodgement during percutaneous transhepatic cholangioscopy
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Published on: September 13, 2022
K Tamada1, A Ohashi, T Tomiyama
1Department of Gastroenterology, Jichi Medical School, Yakushiji, Tochigi, Japan.
Background:
We evaluated the utility of the double-catheter method to establish the track for percutaneous transhepatic cholangioscopy (PTCS).
Methods:
Dilatation of the percutaneous transhepatic track to 16F for PTCS was attempted in 105 patients. The results were prospectively analyzed. Using the single-catheter method (n = 22), a 16F PTCS catheter was replaced without the inner catheter. Using the double-catheter method (n = 83), a 7F catheter with a balloon tip was inserted through a 16F PTCS catheter. The balloon was located distal to the major duodenal papilla. The double-catheter method was further subclassified as follows: Method 2A (n = 62), the tip of the outer catheter (16F) was not advanced through biliary stenoses; Method 2B (n = 21), the catheter was advanced through biliary stenoses.
Results:
In the patients treated by the double-catheter method, dislodgement of the catheter did not occur, whereas the single-catheter became dislodged in 18% (p < 0.0005). The morbidity of method 2A (0%) was less than that of method 2B (14%) (p < 0.005).
Conclusion:
The double-catheter method prevents dislodgement of the PTCS catheter. The outer catheter should not be advanced to the biliary stenosis.
