Percutaneous transhepatic cholangiography

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Percutaneous transhepatic cholangiography (PTC) is a medical procedure used to visualize the biliary tree and diagnose obstructions or other abnormalities in the bile ducts. This procedure involves the insertion of a needle through the skin and liver tissue into the bile ducts, followed by the injection of a contrast dye to make the bile ducts visible on X-ray imaging.

Indications

PTC is typically indicated in patients with jaundice, unexplained abdominal pain, or suspected biliary obstruction. It is also used to evaluate the anatomy of the bile ducts before surgery or endoscopic retrograde cholangiopancreatography (ERCP).

Procedure

The procedure is usually performed under local anesthesia and may be guided by ultrasound or fluoroscopy. The steps involved in PTC include:

1. The patient is positioned, and the skin over the liver is cleaned and sterilized.
2. Local anesthesia is administered to numb the area.
3. A thin needle is inserted through the skin and liver tissue into a bile duct.
4. Contrast dye is injected through the needle to outline the bile ducts on X-ray images.
5. X-ray images are taken to visualize the bile ducts and identify any obstructions or abnormalities.

Complications

While PTC is generally safe, it carries some risks, including:

• Bleeding
• Infection
• Bile leakage
• Pneumothorax

Alternatives

Alternatives to PTC include endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP). These methods may be preferred depending on the patient's condition and the specific clinical scenario.

See also

• Biliary tree
• Endoscopic retrograde cholangiopancreatography
• Magnetic resonance cholangiopancreatography
• Jaundice
• Abdominal pain