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The diagnosis of proctated jaundice is done in 50% of all cases by clinical examination; in 30% of all cases by peritoneoscopy; in the other 20% instrumental opacification of the biliary tract is required (before the laparotomy) in order to determine the site and the nature of the cholestasis. Among these instrumental devices, a transhepatic cholangiography with the Okuda needle allows biliary tract opacification in 98% of all cases if the obstacle is extra-hepatic and in 69% of all cases if the obstacle is intra-hepatic. This technique is easy to perform, without danger, and readily available to any physician. It should be performed after the peritoneoscopy and before the retrograde cholangiography.
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