Juler G L, Conroy R M, Fuelleman R W
Arch Surg. 1977 Aug;112(8):954-8. doi: 10.1001/archsurg.1977.01370080052008.
Percutaneous transhepatic cholangiography (PTC) for jaundice of undetermined etiology was performed with the Chiba needle in 30 patients. Successful visualization of the biliary ductal system was accomplished in 26 patients (86.7%); two of six patients (33.3%) with normal biliary systems had ducts visualized, and the ducts were visualized in the 24 patients (100%) with obstruction. Bile leakage of 50 to 500 ml (average, 200 ml) was observed at laparotomy or autopsy in 12 patients (40%), nine (30%) of whom had symptoms of peritonitis. Six (20%) of these were transient and three (10%) progressed to an acute abdomen. Bacteremia occurred in seven patients (23.3%), in three (10%) it progressed to septic shock, with one death (3.3%). There were no complications in patients with nonobstructed ducts. This study suggests that PTC with the Chiba needle has little advantage over the larger sheathed needles, and surgical standby is indicated in suspected cases of obstructive jaundice.
对30例病因不明的黄疸患者采用千叶针行经皮肝穿刺胆管造影（PTC）。26例患者（86.7%）成功显示了胆管系统；6例胆管系统正常的患者中有2例（33.3%）胆管显影，24例梗阻患者的胆管均显影（100%）。12例患者（40%）在剖腹手术或尸检时观察到50至500毫升（平均200毫升）的胆汁漏，其中9例（30%）有腹膜炎症状。其中6例（20%）为短暂性，3例（10%）发展为急腹症。7例患者（23.3%）发生菌血症，3例（10%）发展为感染性休克，1例死亡（3.3%）。胆管无梗阻的患者未出现并发症。本研究表明，千叶针PTC与较大的带鞘针相比优势不大，对于疑似梗阻性黄疸病例建议做好手术准备。
