PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE OF THE RIGHT HEPATIC LOBE USING THE SUBCOSTAL APPROACH WITH ULTRASOUND GUIDANCE
Keywords:
Drainage, Percutaneous, Bile duct obstruction, Ultrasonography, Interventional, SubcostalAbstract
We present a method for performing transhepatic biliary drainage of the right hepatic lobe under real-time sonographic guidance. With the right subcostal approach, the peripheral bile duct of the anterior inferior right lobe was punctured providing sufficient intrabiliary distance for more multiple side holes to promote better drainage. This puncture site is more comfortable for the patient and easier to care for. With this technique, transpleural puncture or trauma to the intercostal vessels and nerves, which can be complications using conventional techniques, can be avoided. This route can also be used for subsequent permanent placement of the metallic stent. The results and limitations are discussed.
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