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Image 1: Initial Chiba needle guided biliary system opacification.
Image 2: Cobra catheter in situ with biliary system opacification. Chiba needle is also seen.
Image 3: Kinked pigtail drainage catheter due to ascites.
Image 4: A 7 Fr. long sheath in biliary system for drainage.
Chiba needle guided opacification of biliary system was performed.
Pink hub needle guided puncture of right duct system followed by 4Fr. C1 catheter insertion over Terumo Glide wire was performed.
Amplantz stiff wire was then inserted till duodenum though Cobra catheter.
Because of ascites, the pigtail drainage catheter could not be inserted into the biliary duct system (it was getting kinked).
Eventually, A 7 Fr. long sheath was kept in biliary system and sutured externally to skin.