Peripheral portal vein-oriented non-dilated bile duct puncture for percutaneous transhepatic biliary drainage

Figure 2 A 65-year-old man who had undergone segment 5 resection and radiofrequency ablation in segment 1 for hepatocellular carcinoma presented with bile leakage after surgery. A: Computed tomography shows non-dilated intrahepatic bile ducts and an intraperitoneal drainage tube (arrow) placed at the time of surgery; B: Cholangiogram via the endoscopic nasobiliary drainage tube (arrowhead) reveals stricture of the posterior sectional bile duct (arrow). Asterisk shows the intraperitoneal drain placed at the time of surgery; C: Non-dilated peripheral B6 (arrow) is punctured with a 21-G needle. Asterisk shows the intraperitoneal drain placed at the time of surgery; D: An 8-Fr biliary drainage tube is advanced through the strictured right posterior sectional bile duct and placed from B6 to the common bile duct.