https://admin1.seo.com.cn/CustomerAdmin/S_News/Create?ru=%2FCustomerAdmin%2FS_News%2F

In the daily workflow of modern interventional radiology departments, performing Percutaneous Transhepatic Cholangiography (PTC) using the Chiba needle has evolved into a highly standardized operational protocol. The core of this protocol lies in the perfect integration of the Chiba needle's physical characteristics with advanced image-guided technology, aiming to achieve the highest success rate with the lowest possible risk. Preoperatively, physicians must conduct a comprehensive patient evaluation, including coagulation profile tests, iodine allergy screening, and the administration of prophylactic antibiotics. The patient is typically placed in a supine or left lateral decubitus position, with the right mid-axillary region fully exposed.

The first step is precise localization. Under real-time ultrasound monitoring, the physician can clearly observe the course and diameter of the dilated intrahepatic bile ducts and their relationship with surrounding vessels. After selecting a bile duct branch as the target-prioritizing the shortest distance and avoidance of major vessels-the skin entry point is marked. Local anesthesia is then administered, typically using lidocaine infiltrated layer by layer down to the hepatic capsule. At this point, the Chiba needle takes center stage. The standard 22G Chiba needle, with its characteristically sharp bevel, appears on the ultrasound screen as a bright hyperechoic dot. Holding the Chiba needle, the physician carefully adjusts the angle according to the ultrasound guidance line and advances slowly. When the needle tip touches the anterior wall of the bile duct, a subtle sensation of breakthrough is felt-visually corresponding to a slight indentation of the duct wall on the ultrasound image.

Once the bile duct is entered, the first priority is to withdraw the stylet and observe whether bile flows out. This is the gold standard for confirming successful puncture. The thin-wall design of the Chiba needle ensures that even within a tiny 0.7 mm lumen, sufficient negative pressure can be generated to aspirate bile. The obtained bile can be sent for bacterial culture and cytological examination. Next comes the contrast injection phase. Through the hub connector at the tail of the Chiba needle, pre-prepared non-ionic contrast medium is slowly injected. Because the Chiba needle's lumen is extremely fine, the injection must be exceptionally gentle to prevent excessive pressure from introducing air bubbles into the biliary system, which would compromise image quality. As the contrast fills the ducts, the morphology of the biliary tree becomes clearly visible under the X-ray fluoroscope, revealing the location, severity, and extent of any obstruction at a glance. Throughout the entire process, the stability and sharpness of the Chiba needle are critical to the smooth execution of every step; any microscopic defect could lead to puncture failure or increased complication risk. Therefore, strict adherence to standardized protocols is the prerequisite for ensuring the Chiba needle delivers optimal performance in PTC.