Contrast-enhanced ultrasound-guided percutaneous cholangiography and cholangiodrainage (CEUS-PTCD)

We present our experience with contrast-enhanced ultrasound-guided percutaneous transhepatic cholangiodrainage in eight patients with obstructive jaundice and failure of conventional endoscopic retrograde cholangiography. The intraductal application of the ultrasound contrast agent led to sufficient cholangiography in all patients. In one patient, after accidental dislocation of the bile duct drain, the leakage could be detected by demonstration of the passage of contrast agent into the perihepatic peritoneal space. Further studies are necessary to evaluate this new technique in a larger numbers of patients.

References

• 1 Claudon M, Cosgrove D, Albrecht T. et al . Guidelines and good clinical practice recommendations for contrast enhanced ultrasound (CEUS) – update 2008.  Ultraschall Med. 2008;  29 28-44
• 2 Zuber-Jerger I, Endlicher E, Scholmerich J, Klebl F. Endoscopic retrograde cholangiography with contrast ultrasonography.  Endoscopy. 2008;  40 (Suppl. 2) E202
• 3 Bulau S, Berger H, Dittler H J. et al . Arrest of PTCD-induced hemorrhage using a covered vascular metal stent.  Endoscopy. 2000;  32 S57
• 4 Cozzi G, Severini A, Civelli E. et al . Percutaneous transhepatic biliary drainage in the management of postsurgical biliary leaks in patients with nondilated intrahepatic bile ducts.  Cardiovasc Intervent Radiol. 2006;  29 380-388
• 5 Karani J, Fletcher M, Brinkley D. et al . Internal biliary drainage and local radiotherapy with iridium-192 wire in treatment of hilar cholangiocarcinoma.  Clin Radiol. 1985;  36 603-606
• 6 Wittich G R, van Sonnenberg E, Goodacre B W. Radiologic management of hepatolithiasis.  Gastroenterologist. 1998;  6 21-23
• 7 Burke D R, Lewis C A, Cardella J F. et al . Quality improvement guidelines for percutaneous transhepatic cholangiography and biliary drainage.  J Vasc Interv Radiol. 2003;  14 S243-S246
• 8 Lee W, Kim G C, Kim J Y. et al . Ultrasound and fluoroscopy guided percutaneous transhepatic biliary drainage in patients with nondilated bile ducts.  Abdom Imaging. 2008;  33 555-559
• 9 Makuuchi M, Yamazaki S, Hasegawa H. et al . Ultrasonically guided cholangiography and bile drainage.  Ultrasound Med Biol. 1984;  10 617-623
• 10 Sukigara M, Taguchi Y, Watanabe T. et al . Percutaneous transhepatic biliary drainage guided by color Doppler echography.  Abdom Imaging. 1994;  19 147-149
• 11 Takada T, Yasuda H, Hanyu F. Technique and management of percutaneous transhepatic cholangial drainage for treating an obstructive jaundice.  Hepatogastroenterology. 1995;  42 317-322