Percutaneous transhepatic cholangiography in diagnostic evaluation of 160 jaundiced patients. Results of an improved technic.

Percutaneous transhepatic cholangiography (PTC) was carried out in 160 patients with jaundice in whom the diagnosis could not be established by means of conventional methods of investigation. In PTC, selective catheterization of the common bile duct was employed and cholangiograms of high quality were obtained. In patients with obstruction of the biliary passages, the catheter was left indwelling centrally in the biliary passages for external bile drainage. The investigation, thus, did not necessitate immediate operation in these patients. PTC was successful in 113 of the 115 patients with obstructive jaundice. In forty-five patients the suspicion of obstruction could be discharged. Normal biliary passages were demonstrated in twenty-six patients. In nineteen patients it was impossible to cannulate the biliary tree and this was tantamount to nonobstructive jaundice. Complications occurred in six patients, but were not exclusively due to PTC. PTC provides a possibility for differentiation between obstructive and nonobstructive jaundice and thereby laparotomy can frequently be avoided. The incidence of complications may be maintained at an acceptable, low level provided the technic is meticulously observed.