Initial experience of percutaneous transhepatic cholangiography using a fine gauge needle.

Percutaneous transhepatic cholangiography using a fine gauge (Chiba) needle was performed 41 times in 40 patients with jaundice or abnormal liver function. Their ages ranged from 3 months to 80 years and the youngest successful cannulation was carried out on a 15 month-old-child. There were 32 cases of ex-rahepatic biliary obstruction, the site being shown in 28 (87.5%) and the nature correctly predicted in 22 (69%). One of two cases in the post obstructive phase and one of two with intrahepatic cholestasis were cannulated and showed bile ducts of normal calibre. Three out of four cases with hepatocellular disease were successfully examined and obstruction excluded by showing normal bile ducts. Delayed films taken up to 2 h later were found valuable, particularly in cases of obstructive jaundice. The technique is easier and less expensive to perform than endoscopic retrograde cholangiography. No major complications occurred suggesting the modified technique is now a safe procedure for investigating jaundice or disordered liver function in both adults and children.