The Hawkins needle-guide system for percutaneous catheterization: 2. Clinical experience in biliary tract and abscess...

In 1979, a new, 22 gauge needle guide was introduced for combined percutaneous transhepatic cholangiography and biliary drainage procedures. In 103 biliary procedures and 29 abscess drainages using this needle guide, there were no major complications. The use of a small-volume (1-2 ml), low-pressure contrast injection followed by 24 hr of external decompression using self-retaining catheters (Cope loop, accordion) has reduced sepsis as a problem in biliary procedures. Small targets (1-2 cm abscess cavities) can be safely searched for with this 22 gauge needle guide. Two multiloculated abscesses were successfully drained by applying the surgical principle of ingress-egress irrigation catheters for infected cavities.