Fölsch U R, Wurbs D, Classen M, Creutzfeldt W
Dtsch Med Wochenschr. 1979 Apr 27;104(17):625-8. doi: 10.1055/s-0028-1103956.
Results of percutaneous transhepatic cholangiography (PTC) with the Chiba needle were compared with those obtained by endoscopic retrograde cholangiopancreatography (ERCP). PTC was used in 102 cases, most often after ERCP had been inconclusive or had failed. Overall success rate of PTC was 79%. Contrast medium could be injected in only 66% of cases with normal-sized bile passages, but in 98% of those with enlarged passages. The most frequent side effect was temporary pain in the right upper abdominal quadrant. One patient had transitory severe peritoneal irritation with shock. Emergency operation was never required. PTC is technically simpler, takes less time and causes less stress to the patient, but it is less informative than ERCP. If, therefore, both methods are mastered technically, ERCP should be employed first. If it fails to provide the diagnosis, PTC can be performed at once. Biliojejunal anastomoses and pancreatic pseudocysts are absolute indications for the primary use of PTC to investigate the cause of biliary stasis. On the other hand, allergies to iodine or contrast medium and disorders of coagulation are absolute indications for ERCP.
将使用千叶针进行的经皮经肝胆道造影（PTC）结果与通过内镜逆行胰胆管造影（ERCP）获得的结果进行了比较。102例患者使用了PTC，大多数情况是在ERCP未得出结论或失败之后。PTC的总体成功率为79%。在胆管管径正常的病例中，只有66%能够注入造影剂，而在胆管管径增粗的病例中，这一比例为98%。最常见的副作用是右上腹短暂疼痛。1例患者出现短暂的严重腹膜刺激并伴有休克。从未需要进行急诊手术。PTC在技术上更简单，耗时更少，对患者造成的压力更小，但提供的信息比ERCP少。因此，如果两种方法在技术上都已掌握，应首先采用ERCP。如果它未能提供诊断，则可立即进行PTC。胆肠吻合术和胰腺假性囊肿是首选PTC来研究胆汁淤积原因的绝对适应证。另一方面，对碘或造影剂过敏以及凝血功能障碍是ERCP的绝对适应证。
