Direct antegrade cholangiography via transjugular access or as transcutaneous, transhepatic fine-needle cholangiography reduces the examination risk involved in the direct visualisation of the bile duct via needles of thick calibre. The article reports on the results obtained with 83 patients. Direct puncture of the bile duct by means of a fine needle is superior to transjugular antegrade cholangiography in respect of the required technical equipment and cost, and also as far as the proportion of accurate results is concerned, since visualisation of cholangiectasis will always be successful, whereas the visualisation of undilatated bile ducts can be effected in 50% of the examinations. Transvenous access should be chosen in such cases where liver tissue biopsy is necessary. Dilatation of the transcutaneous, transhepatic bile duct access via the temporary transcutaneous, transhepatic bile duct drainage, is necessary in those situations where the bile flow cannot be ensured by surgery, or where surgery is ruled out on account of the patient's general condition.