Transhepatic cholangiography: the radiological method of choice in suspected obstructive jaundice

Twenty-five patients with severe jaundice were studied prospectively with computed tomography (CT), gray-scale ultrasonography (USG), and percutaneous transhepatic cholangiography (THC). Nineteen had obstruction of the biliary tree. The differentiation of obstructive from hepatic parenchymal causes of jaundice was 72% accurate with USG, 92% with CT, and 96% with THC. Biochemical studies when used alone were 72% accurate. Although the precise location of an obstructing lesion was determined in 12/19 cases by CT and 9/19 by USG, the cause was established in only 5 by CT and 7 by USG. THC was 100% successful in establishing both cause and site of obstructive jaundice without significant complications.