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KMID : 0371319630050030177
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Journal of the Korean Surgical Society
1963 Volume.5 No. 3 p.177 ~ p.184
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Percutaneous Transhepatic Cholangiography
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李鐵/Lee, Chul
崔昌祿/Choi, Chang Rok
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Abstract
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The authors have reviewed articles on percutaneous transhepatic cholangiography. Especially the pioneer works on the subject carried out by Burkhardt, Muller, Huard, Rayler, and Galari have been briefly reviewed.
It describes the stated procedure in details and its indications for clinical use and complications. Brief case reports of eight selected cases out of twenty at the hospital follow. In that the authors indicate value in evaluating anatomical and morphological changes of the biliary system. Advantageous aspects of the procedure for evaluating the nature of jaundice over routine Graham and Cole - test which is likely to fail on those cases who are clinically jaundiced, are pointed in individual case.
There are three approaches in performing the procedure; the first, being called as anterior approach each advocated by Carter and Saypol, the second, mid-axillary line approach by Kidd, and the last, posterior or extraperitoneal approach by Prioton. The technical aspects of each approach as to their advantage and disadvantage are fully discussed in order to prevent postoperative complications such as intrahepatic hemorrhage and bile leak.
The works of Housset and Vantsis who tried to measure intraductal and hepatic artery pressures on their three patients, obtaining incidental findings of gradualelevation of. hepatic artery pressure as elevated intraductal pressure is decompressed in the cases of obstructive jaundice, are briefly recorded.
The authors postulate that the procedure may give ´surgeons ample opportunities to prepare for surgery as to what is to be expected in exploration and to decompress the biliary ductal pressure by aspiration, and also to obtain bile specimen for culture ´and chemical analysis preoperatively. They conclude that it´s another added procedure for evaluating the nature of diseases of the biliary trees.
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