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When discussing technical choices for Percutaneous Transhepatic Cholangiography (PTC), the comparative merits of the Chiba needle versus traditional coarse needles remain a hot topic in the field. From an evidence-based medicine perspective, the Chiba needle demonstrates overwhelming advantages in PTC applications. These advantages manifest not only in numerical differences but, more importantly, in patient safety and prognostic outcomes. Traditional coarse needles typically refer to 18G or 19G trocars with outer diameters exceeding 1 mm. In the early days, lacking high-precision image guidance, coarse needles relied on their relatively strong structural support to attempt a one-time penetration of the liver aimed directly at the main bile ducts. However, this crude approach carried extremely high complication risks. The large puncture tract could not close spontaneously, and the incidence of bile peritonitis caused by persistent bile leakage once exceeded 10%. Moreover, inadvertent puncture of adjacent vessels frequently led to fatal hemorrhage.

In contrast, the design philosophy of the Chiba needle is "minimally invasive and precise." Taking the most commonly used 22G Chiba needle as an example, its 0.7 mm outer diameter causes negligible damage when penetrating liver tissue. Research data indicates that the major complication rate of PTC performed with a Chiba needle can be reduced to below 3%. More importantly, the flexibility of the Chiba needle allows the physician to make multiple adjustments at the same puncture site. If the first attempt fails to hit the target bile duct, the physician can withdraw the needle,微调 the angle, and re-advance-without worrying about the cumulative liver damage associated with coarse needles. This enhanced capacity for "trial and error" directly translates into a significantly improved success rate of cholangiographic opacification, which stabilizes at approximately 95% in patients with obvious intrahepatic bile duct dilation.

Furthermore, another hidden advantage of the Chiba needle in PTC is its compatibility with subsequent therapeutic interventions. Although the fine needle itself cannot directly place a drainage catheter, it serves as a tool for establishing initial access. After successful puncture with the Chiba needle, a micro-guidewire can be introduced through the needle lumen, followed by sequential exchanges to place a larger drainage catheter, completing Percutaneous Transhepatic Cholangial Drainage (PTCD). This strategy of "fine-needle puncture with micro-guidewire exchange" preserves the safety profile of the fine needle while achieving the therapeutic goals of the coarse needle-representing a concentrated embodiment of the wisdom of modern interventional medicine. Therefore, whether evaluated from the perspectives of safety, efficacy, or functional extensibility, the Chiba needle has become the undisputed mainstream choice in the field of PTC, driving the continuous advancement of biliary interventional techniques and benefiting countless patients.