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Percutaneous transhepatic puncture with cholangiography was performed on both dilated and nondilated bile ducts. Our indications for examinations have been jaundice of obscure causation, suspected obstruction of the common bile duct without jaundice, and known operative lesions of the biliary tract. The puncture technique allows a catheter to be left in the liver during the examination. Examinations were performed under television fluoroscopy in 68 cases and without it in 37. Puncture of dilated intrahepatic ducts was successful in 50 of 56 attempts. In nondilated ducts, it succeeded in 18 of 35 attempts with roentgen television, and in 1 of 11 without it.
The dangers of complication are reported and discussed. Our experience confirms the need for an immediate draining operation if the examination demonstrates the presence of obstruction to the bile flow.
The percutaneous transhepatic cholangiography is a valuable addition to existing methods of roentgen examination of the biliary tract. When puncture, even of nondilated bile ducts, is possible, the diagnostic value of the method has further increased. It may be feasible as well to study the functional disturbances of the biliary tract with this technique.
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© 1962 Published by Elsevier Inc.