Value of percutaneous transhepatic cholangiobiopsy in the diagnosis of obstructive jaundice
LI Zhen, LI Teng-fei, HAN Xin-wei
Published 2013-09-20
Cite as Chin J Dig Surg, 2013,12(09): 698-702. DOI: 10.3760/cma.j.issn.1673-9752.2013.09.014
Abstract
Objective To investigate the value of percutaneous transhepatic cholangiobiopsy (PTCB) in the diagnosis of obstructive jaundice.Methods The clinical data of 826 patients with obstructive jaundice who received PTCB at the First Affiliated Hospital of Zhengzhou University from April 2001 to December 2011 were retrospectively analyzed.The pathological results,positive rates of PTCB and complications were analyzed.The safety and efficacy of PTCB and the pathological features of malignancy causing obstructive jaundice were summarized.The difference in the positive rates of PTCB for biliary and non-biliary malignancies was analyzed by chi-square test.Results A total of 826 patients received PTCB,and the success rate was 100%.Eighty-six patients had complications postoperatively,including transit bilhaemia in 47 patients,bile leakage in 11 patients,temporary biliary hemorrhage in 28 patients,no severe complications occurred.There were 740 patients were with malignant biliary stricture and 86 with benign biliary stricture.Seven Hundred and twenty-seven patients were with positive results of PTCB (641 were with cancerous stricture and 86 with inflammation of biliary tract or fibrogenesis),and 99 patients were with false negative results.The overall positive rate of PTCB was 88.01% (727/826).Malignant neoplasm accounted for 89.59% (740/826) of the factors causing obstructive jaundice,and well-,moderate-and poor-differentiated neoplasms were accounted for 57.88% (371/641),19.97% (128/641) and 22.15% (142/641).Biliary adenocarcinoma was the main pathologic type,which was accounted for 96.41% (618/641).The positive rates of PTCB for biliary and non-biliary neoplasms were 89.50% (469/524)and 79.63% (172/216),with significant difference (x2 =12.87,P < 0.05).Conclusions PTCB is a safe,feasible and easy way to diagnose obstructive jaundice.Biliary neoplasms are the best indications for PTCB.Well differentiated neoplasm is the main pathological type causing the obstructive jaundice.
Key words:
Obstructive jaundice ; Percutaneous transhepatic cholangiography ; Pathological examination ; Biopsy
Contributor Information
LI Zhen
Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
LI Teng-fei
Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
HAN Xin-wei
Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China