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J Korean Radiol Soc. 1978 Dec;14(2):439-447. Korean. Original Article.
Shinn KS , Chung SK , Lee JM , Moon YC , Yoon SC , Bahk YW .

Flexible-needle percutaneous transhepatic cholangiography has few complications and is valuable indifferential diagnosis of the diseases producing cholestasis. We have performed percutaneous transhepatic cholangiography in 27 patients with jaundice using 23 G flexible-needle at the Dept. of Radiology, St. Mary's Hospital. Catholic Medical College, Seoul. Korea during the period of Jan. 1976 to Sept. 1977. PTC was successfully performed in 26 of 27 patients (96.3%) revealing the following information. There were 11 cases ofbile duct stones, 7 cases of cholangiocarcinomas 2 cases of carcinomas of the head of pancreas, 3 cases of sclerosing cholangitis, 2 cases of chronic pancreatitis and 1 case of clonorchiasis. The cholangiographic findings were (1) well defined rounded intraluminal filling defects or deep meniscus with proximal dilatation in stones.(2) complet obstrctuion of the biliary tree with typical rat-tail appearance in cholangiocarcinomas, (3) complete obstrcution of the biliary tree with funnel-like deformity or nipple appearance in pancreas head carcinoma (4)diffuse thread like narrowing of the bile ducts in sclerosing cholangitis, (5) gradual tapering or obstruction of the distal common bile duct in chronic pancreatitis, (6) numerous small ovoid filling defects within the biliary tree and the gall bladder in clonorchiasis, (7) shallow meniscus in the distal end of the common bile duct inperiampullary carcinoma, and (8) diffuse narrowing of the extra hepatic biliary tract in metastatic carcioma fromthe stomach. The diagnostic accuracy of PTC in 16 operated cases was 93.8%. We were reduced significant lycomplications by using flexible-needle. In addition, decompression was achieved by aspiration of the bile in the patients with high grade obstruction.

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