title: Value of percutaneous transhepatic cholangiobiopsy for pathologic diagnosis of obstructive jaundice: analysis of 826 cases.
abstract: BACKGROUND
  Obstructive jaundice (OJ) is insensitive to radiation and chemotherapy, and a pathologic diagnosis is difficult to make clinically. Percutaneous transhepatic cholangiobiopsy (PTCB) is simple to perform and minimally invasive, and clinical practice has shown it to be an accurate and reliable new method for bile duct histopathologic diagnosis.
  
  
  OBJECTIVE
  To investigate the value of PTCB for pathologic diagnosis of causes of OJ.
  
  
  METHODS
  From April 2001 to December 2011, PTCB was performed in 826 consecutive patients. Data on pathologic diagnosis, true positive rate, and complications were analyzed retrospectively. Patients with negative pathologic findings were diagnosed using clinical, imaging, laboratory, and prognostic data. The feasibility and safety of PTCB for OJ were evaluated and true positive rates for biliary carcinoma and non-biliary carcinoma compared.
  
  
  RESULTS
  PTCB was successful in all cases. Of 740 patients clinically diagnosed with malignant biliary stricture and 86 with benign biliary stricture, 727 received a positive pathologic diagnosis; in 99, the pathologic findings were considered false negative. The true positive rate for PTCB was 88.01% overall, differing significantly for biliary and non-biliary carcinoma (χ2= 12.87, P < 0.05). Malignancy accounted for 89.59% of OJ cases; well, moderately, and poorly differentiated carcinoma represented 57.88%, 19.97%, and 22.15%. Biliary adenocarcinoma was the predominant malignant pathologic type (96.41%). Transient bilemia, bile leakage, and temporary hemobilia occurred in 47, 11, and 28 cases, respectively, with no serious complications.
  
  
  CONCLUSIONS
  PTCB is safe, feasible, and simple, with a high true positive rate for definitive diagnosis of OJ causes. Well differentiated adenocarcinoma was the predominant pathologic type.
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.|Interventional Institute of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.|Interventional Institute of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Teng-Fei
authors.initials: TF
authors.lastname: Li
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.|Interventional Institute of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Jian-Zhuang
authors.initials: JZ
authors.lastname: Ren
authors.affiliation: Department of Pathology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Wen-Cai
authors.initials: WC
authors.lastname: Li
authors.affiliation: Department of Pathology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Jing-Li
authors.initials: JL
authors.lastname: Ren
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China.|Interventional Institute of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Shao-Feng
authors.initials: SF
authors.lastname: Shui
authors.affiliation: Department of Interventional Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, PR China hanxinwei2006@163.com.|Interventional Institute of Zhengzhou University, Zhengzhou, PR China.
authors.forename: Xin-Wei
authors.initials: XW
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001661:Biliary Tract Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D001706:Biopsy / Q000379:methods / Q000706:statistics & numerical data*; D015984:Causality; D002681:China / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000175:diagnosis* / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
keywords: Obstructive jaundice; biopsy; pathology; percutaneous transhepatic cholangiography