What are the indications of percutaneous cholangiography?
PTC is indicated if there is an inaccessible papilla (eg, in ampullary carcinoma or duodenal obstruction from malignancy). Other indications for PTC include the management of postoperative or posttraumatic bile leakage.
What is the percutaneous transhepatic cholangiography used for?
Percutaneous transhepatic cholangiography is a minimally invasive diagnostic and/or therapeutic procedure to evaluate and treat obstruction in the biliary tract. The biliary tract is the drainage system for the liver and gallbladder.
When should a percutaneous transhepatic Cholangiogram PTC be performed?
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 for endoscopic retrograde cholangiopancreatography (ERCP).
What is the contraindication of percutaneous cholangiography?
Uncorrected coagulopathy is a contraindication for PTC, and the normal size of the intrahepatic ducts makes the procedure difficult. Prophylactic antibiotics are recommended to reduce the risk of cholangitis.
Which is better MRCP or ERCP?
A major feature of MRCP is that it is not a therapeutic procedure, while in contrast ERCP is used for both diagnosis and treatment. MRCP also does not have the small but definite morbidity and mortality associated with ERCP.
How percutaneous transhepatic cholangiography is done?
A long, thin, flexible needle is then inserted through the skin into the liver. The provider injects dye, called contrast medium, into the bile ducts. Contrast helps highlight certain areas so they can be seen. More x-rays are taken as the dye flows through the bile ducts into the small intestine.
How long does a PTC procedure take?
How long does the PTC procedure take? The procedure will take approximately one hour. Some children may need to arrive may hours before the procedure to have certain lab tests performed, which will be clearly communicated to you.
Why do MRCP instead of ERCP?
Magnetic resonance cholangiopancreatography (MRCP) is an alternative to diagnostic endoscopic retrograde cholangiopancreatography (ERCP) for investigating biliary obstruction. The use of MRCP, a non-invasive procedure, may prevent the use of unnecessary invasive procedures.
How long does an MRCP last?
The actual MRCP exam takes approximately 10-15 minutes, but it is often performed with a standard MRI of the abdomen, which may last approximately 30 minutes and involves the use of contrast material. In this case, the entire examination is usually completed within 45 minutes.
How is biliary drainage done?
An internal-external biliary drainage catheter goes through your skin and into your bile ducts, across the blockage. One end of the catheter will sit in your small intestine, and the other will come out of your body and will be attached to a drainage bag (see Figure 3).
What color should biliary drainage be?
You will have a drainage bag attached to your catheter. You will see bile (yellow-green fluid) flowing into the bag. The fluid may appear bloody for the first day or 2. The color will eventually be golden yellow or greenish, depending on exactly where the catheter is inside your body.
Where does bile drain to?
Bile moves through a network of tube-like structures called bile ducts to the small intestine, where it helps the body break down and absorb food, and then out of the body through the digestive system. The common bile duct connects the liver, gallbladder and pancreas to the small intestine.
