Percutaneous cholangiography with the Chiba University needle: a new, safe, and accurate method in the diagnosis of cholestatic syndromes.

A modified technique of percutaneous transhepatic cholangiography utilizing the Chiba University needle is described. This new technique employs injection of dye through a thin flexible 22 gauge needle with a short bevel while it is slowly withdrawn under a fluoroscopic monitoring. The results of several investigators are reviewed and indicate that failure to visualize the biliary radicals with the Chiba University needle virtually rules out extrahepatic obstruction. It is anticipated that this technique will replace the traditional sheathed needle cholangiography as a diagnostic modality in the evaluation of the jaundiced patient.