A percutaneous transhepatic cholangiogram (PTHC) is a way to look for something that might be blocking the flow of bile or for other problems in the liver or bile ducts. Bile is a fluid made by the liver and stored in the gallbladder. Bile helps the body digest fats. The bile ducts are the tubes that carry bile from the liver to the gallbladder and to the small intestine.
To make blockages show up on X-rays, a dye is injected directly into the drainage system of the liver. As the dye moves through the ducts, it can be seen on a TV screen. If there is a blockage, the dye shows where the blockage is. Causes of a blockage may be a gallstone, cancer, or other growth.
There are 2 main procedures for looking at the liver, gallbladder, and bile ducts: PTHC and endoscopic retrograde cholangiopancreatography (ERCP).
ERCP is the test of choice because:
PTHC is used when:
Before the test, be sure to let your healthcare provider know if you:
For clear X-ray images, the stomach must be empty. You may be asked not to eat or drink anything after midnight the day of the test, or for at least 8 hours before the test.
The test is often done at an outpatient clinic. It usually takes 30 minutes to 1 hour.
You will be given a local anesthetic to prevent pain. You will also be given a sedative that will relax you and may put you to sleep. You will lie on your back on a table that tilts. The upper right side of your abdomen will be cleaned and then a long, thin, flexible needle will be inserted through your skin high on the right side of the belly into the liver. Dye will be injected through the needle and into the liver. Your healthcare provider will watch the dye moving through the bile ducts on a TV screen. Still X-rays will also be taken. If a blockage is found, your provider may insert a thin flexible tube, called a catheter. This will allow bile to drain into a bag outside the body or into the small intestine.
After the test, you will need to rest in bed for at least 6 hours. This is necessary to make sure there is no bleeding from the site of the injection.
Possible side effects of the dye include:
You may notice soreness for 1 to 2 days at the site where the needle was put into your skin.
The benefits of PTHC are:
The risks of PTHC are:
Call your provider right away if:
Call during office hours if: