A percutaneous transhepatic cholangiogram (PTHC) is an exam that uses X-rays and dye put through a needle inserted through your liver to check your liver, gallbladder, and bile ducts.
The liver and gallbladder are part of your digestive system. Your liver makes bile, which helps your body break down the fat in food. Ducts in the liver carry bile to the gallbladder. The gallbladder is a small sac under your liver on your right side that stores bile. The bile duct carries bile from the gallbladder to the small intestines.
When is it done?
PTHC can find problems such as gallstones, cancer, scar tissue, or other problems. A PTHC is often done when another procedure, called an ERCP canâ€™t be done or has failed. An ERCP is an exam done with a thin, flexible tube with a camera on the end that is passed through your throat and into your small intestines.
How do I prepare for this procedure?
Plan for your care and find someone to give you a ride home after the procedure.
Your healthcare provider will tell you when to stop eating and drinking before the procedure. This helps to keep you from vomiting during the procedure.
Tell your provider if you have had kidney problems or an allergy to chemicals, such as contrast dye. Contrast dye is used for these scans.
Follow your healthcare provider’s instructions about not smoking before and after the procedure. Smokers may have more breathing problems during the procedure and heal more slowly. It is best to quit 6 to 8 weeks before surgery.
Some medicines (like aspirin or Coumadin) may increase your risk of bleeding during or after the procedure. You may or may not need to take your regular medicines the day of the procedure, depending on what they are and when you need to take them. Tell your healthcare provider about all medicines and supplements that you take. Ask your healthcare provider if you need to avoid taking any medicine or supplements before the procedure.
Follow any other instructions your healthcare provider gives you.
Ask any questions you have before the procedure. You should understand what your healthcare provider is going to do. You have the right to make decisions about your healthcare and to give permission for tests or procedures.
What happens during this procedure?
The test may be done at an outpatient clinic. It usually takes 30 minutes to 1 hour.
Before the procedure you will be given medicine to help you relax, but you may be awake during the procedure. You will be given a local anesthetic to numb the area. You will lie on your back on a table that tilts. A long, thin, flexible needle will be inserted through your skin high on the right side of your belly into your liver. Dye will be injected and your healthcare provider will watch the dye moving through the bile ducts on a computer screen. X-rays will also be taken.
If a buildup of bile or a blockage is found, your provider may insert either a thin flexible tube, called a catheter, or a stiff tube, called a stent, through the blockage. This will allow fluid to drain out of the bile duct, either into a bag attached to your side or into your small intestine. It will also prevent bile from building up in your blood or liver. Removing the bile allows your provider to get better X-rays of your bile duct and helps prevent infections or other illness.
If a blockage is found during the test, you may need another procedure or surgery to remove the blockage.
What happens after this procedure?
After the test, you will need to rest in bed for 3 to 6 hours or more.
Ask your healthcare provider:
How and when you will hear your test results
How long it will take to recover
What activities you should avoid, including how much weight you can lift and when you can return to your normal activities
How to take care of yourself at home, especially if you have a bile drainage bag placed
What symptoms or problems you should watch for and what to do if you have them
Make sure you know when you should come back for a checkup.
What are the risks of PTHC?
Your healthcare provider will explain the procedure and any risks. Some possible risks include:
Anesthesia has some risks. Discuss these risks with your healthcare provider.
You may have infection, bleeding, or blood clots.
You may have a collapsed lung.
There is risk with every treatment or procedure. Ask your healthcare provider how these risks apply to you. Be sure to discuss any other questions or concerns that you may have.
Developed by RelayHealth.
Adult Advisor 2015.1 published by RelayHealth. Last modified: 2014-12-22 Last reviewed: 2014-12-22
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.