I. What are the main advantages of the ERCP route for the treatment of obstructive jaundice compared to PTCD? 1, ERCP is performed through the natural lumen of the body (oral cavity and gastrointestinal tract), which avoids part of the invasive procedure and can reduce complications such as bleeding compared to PTCD; 2, ERCP can achieve indirect observation of the duodenal papilla and can perform histological examination (biopsy) during the operation, which has a confirmatory value for partial obstructive jaundice caused by terminal obstruction of the common bile duct; however, for non- 3. For obstructive jaundice due to choledochal stones, ERCP can be performed via the duodenal papilla to remove the cause of the disease while reducing the yellowing; 4. In theory, bilateral, multi-branch bile duct drainage can be performed via the ERCP route without significantly increasing trauma. For multiple bile duct obstructions on the left and right side caused by, for example, biliary stenosis (tumor or non-tumor) in the hilar region, multiple obstructed bile ducts can be drained in one or via multiple treatments to achieve better and faster reduction of bilirubin levels. However, this operation requires a high level of operator skill, and the success rate varies from person to person. What are the main advantages of PTCD over ERCP for the treatment of obstructive jaundice? 1, PTCD directly punctures the intrahepatic bile duct via the right quarter intercostal tissue and a small portion of the liver parenchyma, which significantly shortens the operative path compared to ERCP (the operative path of PTCD is only 20 to 30 cm, whereas the common endoscopic length of ERCP is more than 100 cm), greatly reducing the operational difficulty and increasing the success rate of the operation; 2, for obstructive jaundice caused by tougher obstructions (such as bile duct cancer) 2. for obstructive jaundice caused by tougher obstructions (e.g. bile duct cancer), thanks to the short operation path and smooth angle, PTCD has a much better ability to pass the obstructed segment than the ERCP route, and the treatment success rate for this part of patients is much higher than that of ERCP; 3. in the diagnosis of biliary system diseases, thanks to the short path and imaging equipment that is significantly better than ERCP, the PTCD route has excellent imaging quality and accurate localization ability in diagnosis. Accurate diagnosis is the ultimate guarantee of treatment; 4. PTCD is not affected by bile duct surgery (e.g., biliary-intestinal anastomosis, etc.), while ERCP treatment will be very difficult in this part of patients due to changes in the relative relationship between intestine and bile duct; PTCD may be the only option for this part of patients if biliary obstruction occurs; 5. Thanks to the short route and convenient access, as well as the abundant interventional devices, the The PTCD route is rich in treatment tools, such as balloon dilation, complex stent placement (e.g. Y-shaped), lithotripsy, biopsy, etc.; 6. For stent placement, thanks to excellent imaging guidance, the PTCD route has more accurate positioning than the ERCP route, thus ensuring the effect of yellowing reduction after stent placement; moreover, for complex lesions, the PTCD route can perform stent placement in complex shapes (e.g., Y-shaped bilateral drainage via unilateral access); 8. The duodenal papilla plays an important role in ensuring the relative isolation of the bile duct and the intestinal canal, and its function is destroyed, resulting in repeated fever and other discomfort due to bile reflux. The ERCP route often requires operations such as incision of the duodenal papilla, which can cause permanent damage to its sphincter function; the PTCD route does not require invasive operations on the duodenal papilla and will not adversely affect its function; for general drainage, using new special techniques, the drainage tube can be left at the end of the common bile duct without passing through the duodenal papilla (such as the Y-shaped drainage tube placement technique in our department), which can basically eliminate the need for bile ducts. (such as the Y-shaped drainage tube placement technology of our department), basically can eliminate the occurrence of bile reflux. For the common bile drains, PTCD route has a very rich product line to choose from, with various calibers of drains, flexibility of drains, patency rate, etc., which is much better than the common endotracheal tube (stent tube) of ERCP route.