[Transhepatic percutaneous cholangiography with the Chiba needle in diagnosis of cholestasis]

A technique originally described by Okuda has been employed to study 78 patients suffering from cholestatic syndrome. Visualization of the biliary system was obtained in 70 (89.7%). Of these, 65 presented dilatation of the bile ways whereas in 5, the biliary tree was normal. The 8 cases in which no visualization was obtained were later examined with other techniques and 6 proved to be suffering from intrahepatic cholestasis. In patients with extrahepatic obstruction, the biliary system was visualized in 97%, while in intrahepatic cholestasis, the percentage was 45.5%. The main indication for PTC is the speed at which intrahepatic cholestasis can be distinguished from the extrahepatic type; in the second event, it always pinpoints the site of the impediment, though less frequently the nature of the lesion and its extent. No complications requiring emergency laparotomy were ever encountered. Percutaneous transhepatic cholangiography with Chiba needle is a simple, reliable inexpensive method which gives excellent results in the study of patients with cholestatic syndrome.