What is a percutaneous transhepatic cholangiogram?

A percutaneous transhepatic cholangiogram, or PTC, is an X-ray of the bile ducts (also called the biliary 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.

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.

How is a PTC performed?

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.

Will my child be awake for the procedure?

No. We will use either IV sedation or general anesthesia so that your child isn’t awake.

What risks are associated with the procedure?

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)

Will my child be in any pain after the procedure?

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

When can I remove the bandage?

Leave the bandage on for 48 hours. Then you may remove the clear bandage and gauze; do not remove the Steri-Strips® (white strips). If a drainage catheter was placed, it will be secured with a locking device (StatLock®) which must not be removed.

When can my child bathe?

Keep the site completely dry for the first 48 hours. 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 Steri-Strips have fallen off.