Nonsurgical,percutaneous transhepatic cholangiography—Diagnostic significance in medical problems of the liver

Percutaneous transhepatic cholangiography has been carried out from the right flank on 314 patients with hepatobiliary disease, using a very thin needle. Practically no complication has been encountered in 80 cases with medical problems of the liver. In contrast, such complications as bile leakage, bleeding, shock, fever, and blood pressure drop were experienced in patients with biliary obstruction and stones, though less frequently than reported. The intrahepatic bile ducts were visualized in 67.5% of the patients with no to minimal dilatation, and this high success rate is accounted for by the policy of injecting contrast medium instead of suctioning bile in search of an intrahepatic duct. This technique has proved of value in the diagnosis of intrahepatic cholestasis, inflammation or infection of the bile ducts, space-occupying lesions of the liver, and in elucidating the cause of biliary colics. It sometimes provides unexpected information. It may also serve the same purpose as portography and hepatic arteriography, since these vessel systems run together with the bile duct.