Percutaneous transhepatic cholangiography with selective catheterization of the common bile duct

Percutaneous transhepatic cholangiography was performed in 86 patients with juandice in whom the diagnosis could not be established by conventional means. Selective catheterization of the common bile duct was employed and cholangiograms of high quality were obtained. In cases of obstruction of the biliary passages, the catheter was left indwelling centrally in the biliary passages for external bile drainage. Thus immediate postcholangiogram surgery was not required in these patients. The procedure was successful in all 60 patients with obstructive jaundice. In 26 patients the possibility of obstruction was ruled out. Complications occurred in four patients but were not exclusively due to the procedure. The incidence of complications may be maintained at an acceptably low level if the technique is meticulously followed.