[Biliary peritonitis after percutaneous transhepatic cholangiography with the Chiba technique (author's transl)]

The Chiba technique of percutaneous transhepatic cholangiography (PTC) can be easily learned and does not require much technical equipment; it is thus widely used now in the diagnosis of suspected obstructive jaundice. The procedure is generally regarded as safe; thus standby availability of a surgical outfit is not considered to be necessary. However fever, cholangitis, septicemia, biliary peritonitis and bleeding have been reported in patients who underwent PTC. A case report is given of a patient who had biliary peritonitis following PTC, in order to demonstrate the need for careful selection of patients undergoing this procedure. PTC should not be done in patients with coagulopathy, cholangitis and known allergic reactions against the cntrast medium to be injected. If a dilated duct can be visualized bile should be aspirated and only small amounts of contrast medium be injected. If extrahepatic biliary obstruction has been diagnosed or if the patient complains about pain after the procedure surgery should be done within 24 hours.