Bilateral Internal Drainage of Biliary Hilar Malignancy via a Single Percutaneous Track. Role of Percutaneous Transhepatic Cholangioscopy

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.