Abstract
Strictures of the hepatic bifurcation were bilaterally drained via a single percutaneous
tract in 24 patients with hilar cholangiocarcinoma. This was achieved under percutaneous
transhepatic cholangioscopic (PTCS) guidance which allowed for an excellent manipulation
of the guidewire. Placement of two guidewires, one in the contralateral hepatic duct
and the other in the common duct, was successful in 19 (79 %) of patients at the first
attempt. In the remaining cases the better accessible stricture was dilated, followed
by negotiation of the other stricture under direct cholangioscopic control. After
placement of guidewires into both hepatic ducts, bilateral drainage with a single
Y-shaped catheter could be achieved in all 24 patients. There were no procedure-related
complications. We conclude that this technique might be useful also for application
of other intraluminal adjuvant treatment modalities.