Introduction percutaneous transhepatic cholangiography ptc is a procedure used to access the biliary tree for diagnostic purposes in obstructive jaundice. In many such patients, percutaneous transhepatic cholangiography ptc is the preferred, or only, means of evaluating the biliary tree. The outcomes of biliary drainage by percutaneous transhepatic. Eleven of the 12 patients had had inadvertent biliary trauma during surgery. Is a percutaneous transhepatic cholangiography safe. Percutaneous transhepatic cholangiography ptc diagnostic cholangiography biliary obstruction biliary stricture.
Percutaneous transhepatic cholangiogram baptist health. Percutaneous transhepatic cholangiography ptc superseded intravenous cholangiography. Percutaneous cholangiography was successful in 68 93%. It is a radiologic technique, where a contrast medium is injected into a bile duct prior to executing an xray. Percutaneous transhepatic cholangiography for choledocholithiasis after laparoscopic gastric bypass surgery. Percutaneous transhepatic cholangiogram ptc childrens. If one adheres strictly to the indications and observes careful technic, the hazards are minimal and the information gained rewarding, as illustrated by a detailed report of 1 case. In some cases it can distinguish obstructive from hepatocellular jaundice, and obviate laparotomy on a patient with hepatitis. Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. Ptc is usually performed for evaluation of patients who are found to have biliary duct dilation on ultrasonography or other imaging tests and who are not candidates. The test is performed in a radiology department by an interventional radiologist. Cholangiography, percutaneous transhepatic synonymacronym. Percutaneous transhepatic assistance for duodenoscopic sphincterotomy.
Pdf quality improvement guidelines for percutaneous. Bile leaks at the puncture site after percutaneous transhepatic biliary decompression ptbd are not uncommon and cause a lot of problems for patients with nonresectable biliary malignant obstruction. Complications of percutaneous transhepatic cholangiography ptc. Ptc is a procedure performed by a radiologist specialist xray. Study i the work commenced with a retospective appraisal of the diagnostic value, usefulness and complications of percutaneous transhepatic cholangiography ptc, endoscopic retrograde cholangiopancreatography ercp and ultrasonography of the upper abdomen us in 112 patients with obstructive jaundice. Percutaneous transhepatic cholangiography springerlink. Percutaneous transhepatic cholangiography wikipedia. We, too, are impressed with the diagnostic yield and low morbidity of percutaneous transhepatic cholangiography with the chiba needle as described by pereiras and colleagues ann intern med 86. Percutaneous transhepatic cholangiography should take its proper place in our armamentarium of diagnostic procedures.
A percutaneous transhepatic cholangiogram ptc is an xray of the bile ducts. Quality improvement guidelines for percutaneous transhepatic cholangiography and biliary drainage article in journal of vascular and interventional radiology 149 pt 2. Percutaneous transhepatic cholangiography ptc is a radiographic technique employed in the visualization of the biliary tree and can be used as the first step in a number of percutaneous biliary interventions e. Percutaneous transhepatic cholangiography versus endoscopic retrograde cholangiography for the pathological diagnosis of suspected malignant bile duct strictures. It is usually reserved for patients in whom anatomic considerations preclude safe ercp, such as in the case of an impossible. Radiologists and other doctors use the images to determine if the ducts are underdeveloped or blocked.
However, to the best of the authors knowledge, no study is conducted to establish the causes and to find an appropriate treatment. Percutaneous transhepatic cholangiography for choledocholithiasis after laparoscopic gastric. The radiologist has proven percutaneous transhepatic cholangiography to be a safe, valuable diagnostic method. Percutaneous transhepatic cholangiography with drainage andor stenting relieves jaundice but can be associated with significant morbidity and mortality. Percutaneous transhepatic cholangiography was attempted on 102 occasions at the ochsner foundation hospital from 1952 to 1972. Percutaneous transhepatic cholangiography, when performed by an appropriately trained and experienced interventional radiologist, is a safe procedure which is usually performed under sedation or general anesthesia. Percutaneous transhepatic cholangiography boston childrens. Percutaneous transhepatic cholangiography ptc involves transhepatic insertion of a needle into a bile duct, followed by injection of contrast material to opacify the bile ducts. A contrast medium is injected into a bile duct in the liver, after which xrays are taken. This is an evaluation of percutaneous transhepatic cholangiography, a technique of over eight years standing, previously considered by many authorities as both unrewarding and dangerous. Percutaneous transhepatic cholangiography an overview. Cholangiography, percutaneous transhepatic definition of. Ptu091 percutaneous transhepatic cholangiography ptc.
You will be asked to lie on your back on the xray table. The biliary system was demonstrated in 80 78% patients and biliary ducts were dilated in 73 72%. Complications of percutaneous transhepatic cholangiography ptc article pdf available in the american journal of roentgenology, radium therapy, and nuclear medicine 1172. Ptc also called percutaneous transhepatic cholangiography this procedure is similar to the ercp and takes xray images of the bile duct. Percutaneous transhepatic cholangiography ptc springerlink. Percutaneous transhepatic cholangiography ptc is carried out by various methods according to puncture sites. Percutaneous transhepatic cholangiography annals of. Oct 15, 2018 in most cases, percutaneous transhepatic cholangiography ptc can be performed via the right midaxillary approach, though a subxiphoid approach is occasionally needed. Percutaneous transhepatic cholangiography uptodate. The value and risks of the procedure have been examined in 20.
The role of percutaneous transhepatic cholangiography. These are the tubes that carry bile from the liver to the gallbladder and small intestine. This allowed us to perform electrohydraulic lithotripsy under direct visualization for treatment of choledocholithiasis. Percutaneous transhepatic cholangiography is a therapeutic technique to observe the anatomy of the biliary tract. Stent performance in palliative transhepatic treatment of malignant biliary obstruction. It is usually reserved for patients in whom anatomic considerations preclude safe ercp, such as in the case of an impossible ampullary cannulation. This technique is used for patients with jaundice when the ductal system has been revealed to be dilated by computed tomography ct imaging or ultrasonography but the cause of the obstruction is not clear. Jun 01, 2015 percutaneous transhepatic cholangiography ptc is another technique done for preoperative radiologic examination of the biliary tract. Percutaneous transhepatic cholangiogram what to expect when you arrive all patients must register in the north patient tower 1 hour prior to the procedure and will need a driver after the procedure.
In six patients, the biliary leaks sealed with percutaneous drainage. Percutaneous transhepatic cholangiogram ptc and biliary. Ptc also called percutaneous transhepatic cholangiography. It is suggested that this procedure might be utilized at the operating table in place. Percutaneous transhepatic cholangiography and biliary. If the ducts are blocked, the doctor may place a drainage catheter. Percutaneous transhepatic cholangiography definition of. Guide wire for percutaneous transhepatic cholangiography. The authors describe a new guide wire which facilitates percutaneous passage of a catheter into the bile ducts via the liver and is also helpful in percutaneous pyelostomy. Percutaneous transhepatic cholangiography was first described in 1921 by burkhardt and muller 1 in germany, and again in 1937 by huard and doxuanhop in france. Percutaneous transhepatic biliary drainage ptbd in malignant biliary obstruction was therefore examined in a national cohort to establish risk factors for poor outcomes. Percutaneous transhepatic cholangiography and biliary drainage were performed in 12 patients with major injuries to the bile ducts manifested by biliary leaks and fistulas. Percutaneous transhepatic cholangiography synonyms, percutaneous transhepatic cholangiography pronunciation, percutaneous transhepatic cholangiography translation, english dictionary definition of percutaneous transhepatic cholangiography.
Oct 16, 2014 percutaneous transhepatic cholangiography. As with all invasive procedures, complications and side effects may occur. However, their paper raises some important questions. Ptc is sometimes performed at the same time as a liver biopsy. Compared with ercp, percutaneous transhepatic cholangiography ptc is time consuming, more involved, and likely more stressful for a patient. Percutaneous transhepatic cholangiogram ptc and biliary drainage.
D introduction percutaneous transhepatic cholangiography is a safe and effective technique for evaluating. Percutaneous transhepatic cholangiography and peroral cholangioscopy and pancreatoscopy are discussed separately. Percutaneous transhepatic cholangiography technique. Percutaneous transhepatic cholangiography pthc is an xray test used to identify obstructions either in the liver or bile ducts that slow or stop the flow of bile from the liver to the digestive system. Percutaneous transhepatic cholangiography ptc is usually more valuable than endoscopic retrograde cholangiography. However, direct access to the biliary tree via a percutaneous tube is not always available, particularly in the late postoperative period. Percutaneous transhepatic biliary drainage for bile leaks and. Diagnosis and management of complications from percutaneous. The biliary tree and common duct can be normal with good flow of contrast material into the duodenum. Cholangiography, percutaneous transhepatic daviss lab.
American journal of interventional radiology causes and. Some patients eg, those with a cholangiocarcinoma involving the hilum and central right and left hepatic ducts may require bilateral access. Complications of percutaneous transhepatic cholangiography. Percutaneous transhepatic cholangiography radiology. Percutaneous transhepatic cholangiography jama surgery. In the very ill patient much information can be obtined with relatively little trauma or discomfort. Percutaneous transhepatic cholangiography, however, will reveal the pathologic anatomy of the biliary tree in the presence of jaundice. Percutaneous transhepatic cholangiography pthc or ptc or percutaneous hepatic cholangiogram is a radiological technique used to visualize the anatomy of the biliary tract. Percutaneous transhepatic cholangiography and drainage is an effective rescue therapy for biliary complications in liver transplant recipients who. Since then many reports have attested to the value of. A percutaneous transhepatic cholangiogram, or ptc, is an xray of the bile ducts also called the biliary ducts. Common use to visualize and assess biliary ducts for causes of obstruction and jaundice, such as cancer or stones.