Seven cases of unintentional puncture of the gallbladder occurred during percutaneous transhepatic cholangiography. Adequate visualization of the biliary tree was obtained in each case. Biliary leakage developed in one patient who had complete obstruction due to carcinoma of the pancreas. As more percutaneous transhepatic cholangiography is performed, we may expect more instances of inadvertent puncture of the gallbladder to appear. Suggestions are offered that may help reduce the complications and yet allow the procedure to be performed even in instances where puncture of the gallbladder seems inevitable.
DeMasi CJ, Akdamar K, Sparks RD, Hunter FM. Puncture of the Gallbladder During Percutaneous Transhepatic Cholangiography. JAMA. 1967;201(4):225-228. doi:10.1001/jama.1967.03130040021007