{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:54:43Z","timestamp":1790891683584,"version":"4.1.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n The aim of this study was to explore the clinical application value of percutaneous transhepatic biliary drainage (PTCD) combined with intraductal forceps biopsy in the diagnosis of malignant biliary obstruction (MBO) and to analyze the mechanisms by which obstruction site and sampling quantity influence diagnostic efficacy.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We retrospectively analyzed the clinical data of 47 patients with MBO who underwent PTCD combined with intraductal biopsy. The cohort was stratified into a hilar group (n=27) and a distal group (n=20). The study focused on evaluating the impact of sampling quantity and biochemical markers while comparing the characteristics of the 2 groups.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n The technical success rate of the procedure was 100%. The overall pathologic diagnostic sensitivity was 85.1% (40\/47). The biopsy positivity rate in the distal group (90.0%) was numerically slightly higher than that in the hilar group (81.5%), although the difference was not statistically significant (\n P<\/jats:italic>\n =0.682). In contrast, the median number of samples in the confirmed positive group was significantly higher than that in the negative\/indeterminate group (\n P<\/jats:italic>\n =0.005). Furthermore, the postoperative complication rate was only 6.38%, with no severe adverse events reported.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n PTCD combined with intraductal forceps biopsy is a safe and effective diagnostic method. Although the difference between obstruction sites was not statistically significant, this study demonstrates that increasing sampling quantity is crucial for diagnosis. Obtaining at least 3 to 4 samples through multipoint sampling is recommended to ensure high diagnostic rates across different obstruction sites.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/sle.0000000000001477","type":"journal-article","created":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T19:00:15Z","timestamp":1781290815000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic Efficacy and Spatial Factors of Percutaneous Transhepatic Cholangiobiopsy in Malignant Biliary Obstruction: A Comparative Analysis of Hilar Versus Distal Obstruction"],"prefix":"10.1097","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3802-0385","authenticated-orcid":false,"given":"Qingfan","family":"Hao","sequence":"first","affiliation":[{"name":"Department of Interventional Radiology, Renmin Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Sinopharm Dongfeng General Hospital, Hubei University of Medicine, Shiyan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,10]]},"reference":[{"key":"R1-20261001","doi-asserted-by":"crossref","first-page":"415","DOI":"10.2147\/CEG.S195714","article-title":"Early diagnosis and management of malignant distal biliary obstruction: a review on current recommendations and guidelines","volume":"12","author":"Fernandez Y Viesca","year":"2019","journal-title":"Clin Exp Gastroenterol"},{"key":"R2-20261001","first-page":"379","article-title":"Validity of ultrasonography in diagnosing obstructive jaundice","volume":"82","author":"Admassie","year":"2005","journal-title":"East Afr Med J"},{"key":"R3-20261001","doi-asserted-by":"crossref","first-page":"104","DOI":"10.11648\/j.crj.20150305.13","article-title":"The role of multidetector row computed tomography in biliary tract malignancy","volume":"3","author":"Narayanaswamy","year":"2015","journal-title":"Cancer Res J"},{"key":"R4-20261001","first-page":"1","article-title":"Deep learning-assisted diagnosis of extrahepatic common bile duct obstruction using MRCP imaging and clinical parameters","volume":"21","author":"Thoi","year":"2025","journal-title":"Curr Med Imaging"},{"key":"R5-20261001","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.gie.2014.09.017","article-title":"Comparative effectiveness of biliary brush cytology and intraductal biopsy for detection of malignant biliary strictures: a systematic review and meta-analysis","volume":"81","author":"Navaneethan","year":"2015","journal-title":"Gastrointest Endosc"},{"key":"R6-20261001","doi-asserted-by":"crossref","first-page":"3262","DOI":"10.1038\/s41598-023-28058-5","article-title":"Diagnosing malignant distal bile duct obstruction using artificial intelligence based on clinical biomarkers","volume":"13","author":"Sugimoto","year":"2023","journal-title":"Sci Rep"},{"key":"R7-20261001","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1055\/s-2008-1074762","article-title":"Complications of percutaneous biliary drainage and stricture dilatation","volume":"11","author":"McNicholas","year":"1994","journal-title":"Semin Intervent Radiol"},{"key":"R8-20261001","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4103\/0973-1075.173958","article-title":"Unilobar versus bilobar biliary drainage: effect on quality of life and bilirubin level reduction","volume":"22","author":"Gamanagatti","year":"2016","journal-title":"Indian J Palliat Care"},{"key":"R9-20261001","doi-asserted-by":"crossref","first-page":"4291","DOI":"10.1007\/s00330-017-4796-x","article-title":"Percutaneous transluminal forceps biopsy in patients suspected of having malignant biliary obstruction: factors influencing the outcomes of 271 patients","volume":"27","author":"Park","year":"2017","journal-title":"Eur Radiol"},{"key":"R10-20261001","doi-asserted-by":"crossref","first-page":"38","DOI":"10.4038\/slaj.v4i1.113","article-title":"Anatomical landmarks for Percutaneous Transhepatic External Biliary Drainage (PTBD)","volume":"4","author":"Udupihilla","year":"2020","journal-title":"Sri Lanka Anat J"},{"key":"R11-20261001","first-page":"1125","article-title":"Treatment of malignant biliary occlusion by means of transhepatic percutaneous biliary drainage with insertion of metal stents\u2014results of an 8-year follow-up and analysis of the prognostic parameters","volume":"175","author":"Alfke","year":"2003","journal-title":"RoFo Fortschr Geb Rontgenstr Nuklearmed"},{"key":"R12-20261001","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1177\/030089169908500301","article-title":"Percutaneous intraductal sampling for cyto-histologic diagnosis of biliary duct strictures","volume":"85","author":"Cozzi","year":"1999","journal-title":"Tumori J"},{"key":"R13-20261001","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1590\/0100-3984.2017.0228","article-title":"Percutaneous transhepatic cholangiobiopsy","volume":"52","author":"Nunes","year":"2019","journal-title":"Radiol Bras"},{"key":"R15-20261001","first-page":"1162","article-title":"Biopathological characteristics of hilar cholangiocarcinoma and the clinical significance","volume":"47","author":"Yu","year":"2009","journal-title":"Zhonghua Wai Ke Za Zhi"},{"key":"R16-20261001","doi-asserted-by":"crossref","first-page":"48","DOI":"10.24976\/Discov.Med.202436180.4","article-title":"Exploring molecular mechanisms in the second-line treatment of biliary tract malignant tumors","volume":"36","author":"Liu","year":"2024","journal-title":"Discov Med"},{"key":"R17-20261001","doi-asserted-by":"crossref","first-page":"e101","DOI":"10.1097\/MPA.0000000000002401","article-title":"Combined endoscopic ultrasonography and endoscopic retrograde cholangiopancreatography in patients with malignant distal biliary obstruction is associated with reduced time to oncological therapy compared with ERCP and sampling alone","volume":"54","author":"Gauci","year":"2025","journal-title":"Pancreas"},{"key":"R18-20261001","first-page":"568","article-title":"Treatment of malignant biliary tract obstruction: endoscopic or percutaneous transhepatic biliary drainage","volume":"22","author":"Li","year":"2016","journal-title":"Chin J General Surg."},{"key":"R19-20261001","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1080\/13645706.2022.2079381","article-title":"Percutaneous transluminal forceps biopsy with an adjustable curved sheath for obstructive jaundice","volume":"31","author":"Tian","year":"2022","journal-title":"Minim Invasive Ther Allied Technol"},{"key":"R20-20261001","doi-asserted-by":"crossref","first-page":"2324","DOI":"10.1111\/jgh.15497","article-title":"Factors affecting the diagnostic yield of endoscopic transpapillary forceps biopsy in patients with malignant biliary strictures","volume":"36","author":"Yang","year":"2021","journal-title":"J Gastroenterol Hepatol"},{"key":"R21-20261001","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.gie.2014.04.029","article-title":"EUS-guided, through-the-needle forceps biopsy: a novel tissue acquisition technique","volume":"81","author":"Samarasena","year":"2014","journal-title":"Gastrointest Endosc"},{"key":"R22-20261001","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.3348\/jksr.2023.0063","article-title":"Predictive factors for symptomatic dislodgement of percutaneous transhepatic biliary drainage catheter in patients with malignant biliary obstruction","volume":"84","author":"Yu","year":"2023","journal-title":"J Korean Soc Radiol"},{"key":"R23-20261001","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.2214\/ajr.148.6.1207","article-title":"Complications of percutaneous biliary drainage: benign vs malignant diseases","volume":"148","author":"Yee","year":"1987","journal-title":"Am J Roentgenol"},{"key":"R24-20261001","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/j.surg.2018.10.015","article-title":"Pleural dissemination of cholangiocarcinoma caused by percutaneous transhepatic biliary drainage during the management of resectable cholangiocarcinoma","volume":"165","author":"Yamashita","year":"2019","journal-title":"Surgery"},{"key":"R25-20261001","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.surg.2016.08.008","article-title":"Verification of the oncologic inferiority of percutaneous biliary drainage to endoscopic drainage: a propensity score matching analysis of resectable perihilar cholangiocarcinoma","volume":"161","author":"Komaya","year":"2017","journal-title":"Surgery"}],"container-title":["Surgical Laparoscopy, Endoscopy & Percutaneous Techniques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.1097\/SLE.0000000000001477","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T21:00:26Z","timestamp":1790888426000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1097\/SLE.0000000000001477"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,4]]},"references-count":24,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.1097\/sle.0000000000001477","relation":{},"ISSN":["1534-4908","1530-4515"],"issn-type":[{"value":"1534-4908","type":"electronic"},{"value":"1530-4515","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6,4]]},"assertion":[{"value":"2026-02-10","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-14","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}