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Fig. 3 | Insights into Imaging

Fig. 3

From: Triple guidance of choledochoscopy, ultrasonography, and computed tomography facilitates percutaneous catheter drainage of infected walled-off necrosis

Fig. 3

Images of modified percutaneous catheter drainage under the triple guidance of choledochoscopy, ultrasonography, and computed tomography. a After puncture by the trocar (red arrow), the core is withdrawn to establish a channel for the choledochoscope. b The cholangioscope (red arrow) is introduced through the trocar (red triangle), and the condition of the inner walled-off necrosis (WON) is observed by the choledochoscope (b1) and ultrasonography (b2, red arrow indicates the choledochoscope) in real time, followed by introduction of a guide wire to target the lowest part of the WON (b3). c A multi-side-hole catheter (red arrows, 16 Fr) is inserted along the guidewire to fully drain the WON, and abscess accumulation is observed by contrast-enhanced ultrasonography. d The liquefied necrotic tissue (red triangle) is successfully drained using the catheter (red arrow) and verified by contrast-enhanced ultrasonography (d1)

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