Percutaneous transhepatic choledochoenterostomy in a patient with a biliary obstruction

A needle guide was used to create a fistula from an obstructed common bile duct to the duodenum in a patient with a large tumor of the head of the pancreas. The tortuosity and severity of the stricture prevented the use of routine guide wire passage. A 5-F hyperalimentation catheter was also placed, in addition to the biliary drainage stent.