The role of percutaneous transhepatic biliary biopsy in the diagnosis of patients with obstructive jaundice: an initial experience

Abstract Objective: To evaluate the accuracy of percutaneous transhepatic biliary biopsy (PTBB) in patients with suspected biliary obstruction. Materials and methods: This was a retrospective analysis of 18 patients with obstructive jaundice who underwent PTBB. In each patient, three to ten fragments were collected from the lesion. The final diagnosis was confirmed in the pathology report. We also reviewed analyses of the results of laboratory tests performed before the procedure, as well as the Bismuth classification, clinical outcome, complications occurring during the procedure, access route, and materials used. Results: Technical success was achieved in 100% of the PTBB procedures. Among the 18 patients clinically diagnosed with bile duct stenosis, the pathological analysis confirmed that diagnosis in 17. In one case, the pathological findings were considered false-negative. The predominant tumor was cholangiocarcinoma (seen in 50% of the cases). Sixteen of the procedures (88.9%) were performed without complications. Transient hemobilia occurred in one case, and cholangitis occurred in another. Conclusion: PTBB is a safe, viable, simple technique with a high rate of true-positive results for the definitive diagnosis of obstructive jaundice.

摘要 研究目的：评估经皮肝穿胆道活检（percutaneous transhepatic biliary biopsy, PTBB）对疑似胆道梗阻患者的诊断准确性。材料与方法：本研究为回顾性分析，纳入18例接受经皮肝穿胆道活检的梗阻性黄疸患者。每位患者从病变部位采集3~10份组织碎片。最终诊断经病理报告证实。本研究同时回顾分析了操作前实验室检查结果、Bismuth分型、临床转归、操作相关并发症、入路途径及所用耗材。结果：所有经皮肝穿胆道活检操作均实现技术成功，成功率达100%。在18例临床诊断为胆管狭窄的患者中，病理分析证实17例符合该诊断，1例病理结果为假阴性。主要肿瘤类型为胆管癌，占所有病例的50%。16例操作（占比88.9%）未发生并发症，1例出现一过性胆道出血，另1例发生胆管炎。结论：经皮肝穿胆道活检是一种安全、可行且简便的技术，对梗阻性黄疸的明确诊断具有较高的真阳性检出率。