RECENT reports from Japan describing percutaneous transhepatic cholangiography (PTC) with a new, thin needle have suggested this technique to be unusually reliable and safe.1 We have performed PTC with the "Chiba needle" in 40 patients with suspected biliary tract obstruction or jaundice of uncertain cause.
The needles used in this procedure were developed at Chiba University, Chiba, Japan. This very flexible needle with stylet is made of steel, 15 to 17 cm long and 0.7 mm in diameter. A radiopaque marker (coin) was placed on the xiphoid process. The needle entry site was usually in the midaxillary line at the level of the eighth or ninth intercostal space. The needle was inserted parallel to the x-ray table, attempting to position its tip just under the coin marker but not beyond the midvertebral line. Throughout the procedure the patients were permitted normal respiration. After removing the stylet, contrast medium was
Redeker AG, Karvountzis GG, Richman RH, Horisawa M. Percutaneous Transhepatic CholangiographyAn Improved Technique. JAMA. 1975;231(4):386-387. doi:10.1001/jama.1975.03240160050023