Percutaneous ultrasound-guided cholangiography using microbubbles to evaluate the dilated biliary tract: initial experience

Objective To evaluate the feasibility of percutaneous ultrasound cholangiography (PUSC) with a microbubble contrast agent in assessing obstructive bile duct diseases. Methods PUSC and percutaneous transhepatic cholangiography (PTC) were performed in 58 patients with obstructive jaundice undergoing ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD). The PUSC findings were compared with PTC using the Chi-squared test Results The accuracy of PUSC in determining the level of hilar obstruction and extrahepatic obstruction was 100% (26/26) and 93.3% (30/32), while the accuracy of PTC was 100% for both (P = 1.000, P = 0.492, respectively). The accuracy of PUSC in determining the cause of hilar obstruction and extrahepatic obstruction was 92.3% (24/26) and 93.8% (30/32), respectively, while the accuracy of PTC was 84.6% (22/26) (P = 0.675) and 75% (24/34) (P = 0.039), respectively. Conclusion PUSC is comparable to PTC in depicting the anatomy of the dilated bile duct tree and determining the level of obstruction for patients with obstructive jaundice, hence it expands the capacity of ultrasound in evaluating obstructive bile duct disease and simplifies the procedure of assessing obstructive jaundice. Key Points Percutaneous ultrasound-guided cholangiography with microbubbles offers a new form of cholangiography PUSC compares well with PTC in evaluating the dilated biliary tract. Radiation is avoided and overall costs may be lower.