"Japanese needle" transhepatic cholangiography. Experience in 98 cases and review of the literature.

Percutaneous transhepatic cholangiography (PTC) using the "Japanese needle" technique as described by Okuda et al. was performed in 98 patients. The overall success rate in cannulating bile ducts with this technique has been 91.8%. Nondilated bile ducts were successfully cannulated in 82.8% of the patients and nondilated bile ducts were successfully seen in 96.8% of the patients. Ten patients were found to have by PTC an obstructive jaundice without significant dilatation of the common bile duct or intrahepatic radicles. Exploratory laparotomy was avoided in 19 of 23 patients with nonobstructive jaundice as demonstrated by this technique. Major complications were present in 2 patients, no deaths were attributed to this procedure. The main advantages of the use of this needle compared with the conventional 8-20 gauge needle are (1) diminished discomfort to the patient, (2) increased complication rate, (3) ability to cannulate normal size bile ducts and (4) elimination of the need for immediate surgery after the procedure.