Practical experience with percutaneous nephrostomy: avoidance of common technical pitfalls

In our 18-month experience with percutaneous nephrostomy (PCN) at Vanderbilt University Hospital and Veterans Administration Hospital (Nashville), a total of 47 PCNs were attempted with a success rate of 96%. The procedure is rapid, offers low morbidity, and has been readily accepted. Some variations of the standard procedure to avoid common technical difficulties include (1) using a combination of real-time ultrasonography and fluoroscopy as a guidance system, (2) maintaining the position of the Chiba needle during the entire procedure, (3) choosing the optimal puncture site, and (4) exercising care in tract dilatation.