A 55-year-old man with jaundice due to peritonitis carcinomatosa from gastric cancer. A: The virtual CT sonographic image (left) displayed with the corresponding B-mode sonogram (right) shows the dilated bile duct (B3: arrow). The virtual image shows that the stomach cavity (arrow head) is close to the lateral segment of the liver. However, a B-mode sonogram cannot show the stomach cavity in the same view. The virtual image helps to determine the safe puncture route. B: The radiograph shows successful internal-external bile duct drainage using a 8.5 French drainage catheter. C: The CT image shows that the drainage catheter is inserted into the bile duct through the route planned before the procedure using the RVS system. CT: computed tomography.