- Fluoroscopy control of biliary tree puncture and defining common bile duct (CBD) occlusion level.
Step-by-step images of first part of stenting common bile duct (CBD) procedure: from biliary tree puncture to proper catheter placement.
Ultrasound guided puncture of right-lobe intrahepatic biliary tree. Contrast agent filling the biliary tree confirms proper needle placement.
Care must be taken as minimal needle movement will result with losing its proper intrabiliary position.
Further biliary contrast filling through soft introduction needle. Needed for most distal ducts visualisation.
Guide wire placed in the furthest part of biliary tree - will be used for changing introduction needle for angled catheter.
Angled catheter mounted in the beginning of stricture. Using this catheter hydrphilic guide wire will be used to traverse the patent part of common bile duct.