[Transhepatic fine needle cholangiography. Retrospective study of 60 patients]

The purpose of this study was to present the retrospective results of 60 percutaneous transhepatic cholangiograms performed with a Chiba needle between 1978 and 1980 in a general radiology department. The puncture technique is now well established and the use of the Chiba needle considerably diminished the risk of local complications. The incidence of local complications is 5%. The complications are mainly due to the high pressure in the dilated bile ducts which can favorize infection and intraperitoneal bile effusion. When the right technique is used excellent imaging of the biliary system can be obtained. A correct diagnosis can be made in 95% of cases. The main indication of percutaneous transhepatic cholangiography is the obstruction of the main bile duct. The usual cases are: carcinoma of the head of the pancreas, carcinoma of the ampulla and other tumors of the main bile duct, neoplastic or inflamatory stenosis of the main bile duct, common duct stones and postoperatory complications of the biliary surgery. The errors of interpretation can be due to the difficulty to analyze the terminal portion of the bile duct or to false defects due to inhomogeneity of the contrast medium or a thick bile. The low complication rate and ist easy performance make the percutaneous transhepatic cholangiography competitive with the retrograde endoscopic opacification of the biliary system.