Percutaneous Transhepatic Cholangiogram

A percutaneous transhepatic cholangiogram, or PTC, is an X-ray of the bile ducts (also called the biliary ducts). Bile is a substance that helps digest fats. It is made in the liver and stored in the gallbladder. After meals, it is excreted into the intestines via the bile ducts.

Radiologists and other doctors use the images to determine if the ducts are underdeveloped or blocked. If the ducts are blocked, the doctor may place a drainage catheter. PTC is sometimes performed at the same time as a liver biopsy.

Procedure

Using ultrasound and live X-ray (fluoroscopy) for guidance, the radiologist will insert a small needle through the skin and liver and into one of the bile ducts. Then the radiologist will inject X-ray dye into the ducts and X-ray images will be obtained. Your child will be protected by an X-ray shield during this procedure. A bandage will be placed over the injection site following the procedure.

Anesthesia

Patients receive either IV sedation or general anesthesia and are asleep for this procedure.

Risks

The procedure is considered low-risk. However, potential complications include:

• bleeding
• infection
• injury to the gallbladder
• bile leak (biloma)
• puncture of the lung (very rare)
• allergic reaction to X-ray dye (contrast reaction)

Pain

Some children feel pain or discomfort at the needle-insertion site, usually in the first day or two after the procedure. You may give your child over-the-counter pain medication to ease discomfort.

Bathing

Leave the bandage on for 48 hours and keep it dry. After 48 hours, you may remove the clear bandage and gauze. Do not remove the white Steri-Strips®. If a drainage catheter was placed, it will be secured with a StatLock® locking device which must not be removed.

After 48 hours, your child may shower or have a sponge bath, but you should continue to keep the area dry. Do not submerge the site in water (bath or pool) until the white Steri-Strips have fallen off.