Fine needle transhepatic cholangiography: a new approach to obstructive jaundice.

Transhepatic cholangiography performed with a newly introduced fine caliber (0.7 mm OD) "Chiba" needle produces a significantly higher success rate of biliary duct opacification with fewer complications than conventional needle or flexible cannula techniques. Distinct advantages over endoscopic retrograde cholangiography are also apparent, including more frequent bile duct opacification, ease of performance, and lower overall cost. In a group of 50 consecutive patients examined with the fine needle puncture technique, duct opacification was achieved in 92%, including 33 of 33 (100%) of patients with surgically obstructed ducts and 14 of 17 (82%) with normal caliber or narrowed ducts. Fine needle hepatic puncture is recommended as the preferred approach for direct biliary duct opacification in jaundiced patients.