Percutaneous transhepatic cholangiography using the Chiba needle: comparison with retrograde pancreatocholecystography.

We have reviewed 103 consecutive percutaneous transhepatic cholangiograms (PTC). Although 70% of these examinations were performed by inexperienced radiologists, the success rate for entering bile ducts (overall 87.4%; in obstruction 98.5%; in nonobstructed cases 65.7%) and the complication rate (12.6%) is similar to that reported in large series by experienced workers. While examiner expertise therefore apparently has little or no influence on the success rate of PTC, the reverse is true for endoscopic retrograde cholangiopancreatography (ERCP). Here the success rate is directly proportional and the complication rate inversely proportional to examiner experience. Since PTC is easier to perform and is more accurate and much less time-consuming and costly than ERCP, it should be the method of choice in the differentiation of obstructive and parenchymal jaundice.