Cholangioscopic microwave tissue coagulation (MTC) and recanalization of the bile duct with complete obstruction due to pancreatic carcinoma in the far advanced stage

In this report, we describe cases of jaundice patients with advanced-stage pancreatic carcinoma in whom recanalization of the bile duct with complete obstruction was achieved after MTC via percutaneous transhepatic cholangioscopy (PTCS), and suggest the utility of PTCS-MTC for the recanalization of complete obstruction of the bile duct due to pancreatic carcinoma in the far advanced stage. With repetitions of cholangioscopic MTC and gentle pushing a thin guide wire, we can usually get the wire pass through the obstructed bile duct. After then, stepwise dilation of the duct by use of covering tubes over the thin wire becomes possible. More often than not, the opposite side of the tip of PTCS catheter is the proper and correct position to begin the procedure of recanalization.