The Hawkins needle-guide system for percutaneous catheterization: 1. Instrumentation and procedure

In 1979, a new 22 gauge "skinny"-needle cannula system was introduced for combined percutaneous transhepatic cholangiography and drainage procedures. This small-bore system safely permits multiple passes when searching for small targets. Once the area of interest is entered, drainage can be accomplished with the same needle insertion by advancing either a 5 French straight Teflon or 6.5 French Teflon retention catheter over the stiff 22 gauge cannula. The distal tip of a catheter is looped using a continuous strand of monofilament, which helps to prevent catheter dislodgment. For 103 cholangiograms attempted, the overall success rate was 97%, including 95% in nondilated intrahepatic biliary tracts, with no major complications.