New transhepatic biliary drainage procedures for safe intubation and early extubation

Background/Aims: The conventional transhepatic biliary drainage method requires a long period of tube placement and a technically difficult intubation. Methodology: New transhepatic biliary drainage methods were applied in cases undergoing an open choledochotomy. The drainage tube was placed transhepatically using a newly developed, rigid and J-shaped needle (J-Needle) with a vertical, ventral and rotating penetration at the proximal hepatic duct. The tube was then introduced directly to the extraperitoneal space by attaching the parietal peritoneum to the liver surface without tube-fixation (extraperitoneal transhepatic tube method). Results: These procedures were applied in 50 patients. The J-Needle was easily and safely inserted without any complications. In the 39 analyzed cases, the patients were safely extubated on postoperative day 7 and discharged around postoperative day 10. Conclusions: The combination of the J-Needle and the extraperitoneal transhepatic tube method is useful for safe transhepatic biliary intubation and early extubation, enabling a shorter hospital stay for patients requiring biliary surgery.