Percutaneous transhepatic cholangiography and needle biopsy in the differential diagnosis of obstruction of bile flow.

Twenty-four patients with clinical evidence of obstructive jaundice were examined by percutaneous transhepatic cholangiography (PTC) and needle biopsy (NB) of liver. The presence of extrahepatic bile duct obstruction was confirmed by surgery in 21 cases. PTC and the combination of both methods were superior to NB alone in the differential diagnosis between extra- and intrahepatic biliary obstruction. Sampling bias added to the difficulties of NB in distinguishing beween these two types of obstruction. The combination of both precedures proved most useful in three cases with intrahepatic obstruction, in which the patients were spared unnecessary surgery. In five cases the NB provided additional information about the nature of the tumor metastases and gave suport to the clinicians in their therapeutic approach.