ABSTRACT
Objective To evaluate the clinical effect of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) combined with endoscopic retrograde cholangio-pancreatography (ERCP) in treating malignant obstructive jaundice, and to discuss its technical points. Methods A total of ten cases with malignant biliary obstruction were enrolled in this study. After the failure of ERCP treatment, the patients had to be treated with ultrasound-guided PTCD immediately. The guide-wire was inserted into the duodenum through intrahepatic bile duct and common bile duct to connect with ERCP, which was followed by the biliary stent implantation or the removal of physical factors causing obstruction. The clinical results were analyzed. Results Technical success was obtained in all 10 cases. In the patients who underwent a successful guide-wire docking with ERCP the postoperative serum bilirubin was significantly decreased. The main complications were fever, elevation of amylase and transient bloody bile. Conclusion With the help of docking technique the combination use of ultrasound-guided PTCD and ERCP is a new tentative treatment for malignant obstructive jaundice after the failure of initial ERCP treatment. This technique carries promising value in clinical practice as it can significantly increase the success rate of ERCP.
ABSTRACT
Objective To elevate the achievement rate of kidney biopsy puncture through the analysis of puncture angle choice of ultrasound guided automatic kidney biopsy in 518 patients. Methods Under the guidance of color Doppler ultrasound,using the 3.5MHz probe with probe holder,we performed kidney biopsy in the degrees of 40°(group X),45°(group Y),60°(group Z) and 70°(group P) with the horizontal plane. Resnlts The total achievement ratio is 100 %. The one time success rate in group Y and group Z is 100 % (group Y, 164/164 ; group Z, 186/186) ;group X is 4.8% (22/46) ;group P is 84.4% (103/122).Conclusion The automatic kidney biopsy an- gle under the guidance of ultrasound should be between 45° and 60° with the horizontal plane which is safe and has higher achievement ratio. In the meantime, complications can be avoided.