Summary:
The main indication for transcutaneous cholangioscopy through a channel of percutaneous trans
hepatic drainage are choledocholithiasis, hepatolithiasis and non malignant or malignant steno
sis of the bile ducts. In our department we were able to treat thus repeatedly also complete
severing of the biliary pathways. Group: Twelve patients with complete severing of the right
hepatic ducst (4x) or common bile duct (8x) after cholecystectomy could not be operated on
account of great surgical risk or adhesions after operation. On account of cholangitis they had
percutaneous transhepatic drainage. After three weeks transcutaneous cholangioscopy was per
formed and recanalization by means of a needle shaped knife. The operation was terminated by
introduction of a metal prosthesis Palmaz. Results: The method was successful in all patients,
there were no complications associated with the procedure. Conclusion: Transcutaneous cholan
gioscopy and recanalization of complete severing of the biliary pathways is a new safe method. It
is indicated in patients with increased surgical risk. For restoration of the continuity of the bile
ducts a metal prosthesis Palmaz is inserted. Short term results of treatment are satisfactors,
long term results call for a longer follow up.
Key words:
Transcutaneous cholangioscopy Percutaneous transhepatic drainage Recanalizati
on of the bile duct Metal prosthesis
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