Percutaneous transhepatic cholangiography (PTC) and percutaneous biliary procedures are minimally invasive techniques used for the evaluation and treatment of the liver's bile ducts. These procedures play an important role in the diagnosis and treatment of obstructions, stones, or other pathologies in the bile ducts. This article will comprehensively address the basic principles, applications, procedural details, complications, and management strategies of PTC and other percutaneous biliary procedures.

What is Percutaneous Transhepatic Cholangiography (PTC)?

Percutaneous transhepatic cholangiography is a procedure performed to visualize the bile ducts of the liver. The term "percutaneous" means done through the skin, and "transhepatic" refers to the procedure performed through the liver. PTC is commonly used to evaluate obstructions, narrowing, or other abnormalities in the bile ducts.

---

Procedure Mechanism

Preparation and Evaluation:
Patient Selection: PTC is typically used in patients suspected of having bile duct obstruction or blockage. The patient's medical history, current condition, and suitability for the procedure are assessed.
Imaging: Prior to the procedure, ultrasound, CT, or MRI are used to determine the condition of the bile ducts. These imaging techniques help identify appropriate areas for needle placement.

Procedure:
Anesthesia: Local anesthesia is generally used. Sedation may also be necessary. Pain relievers and relaxing medications are administered before and during the procedure to reduce pain and ensure patient comfort.
Access Route: A thin needle or catheter is guided to the liver with the help of imaging. Access to the bile duct is gained via the needle.
Contrast Agent Injection: A contrast agent is injected into the bile ducts through the needle. This substance allows detailed visualization of the bile ducts.
Imaging: The cholangiography, using the contrast agent, allows evaluation of obstructions, stones, and other pathologies in the bile ducts.

Conclusion:
Drainage or Treatment: If necessary, bile can be drained through a drainage catheter placed in the bile ducts. Additionally, stones or obstructions in the bile duct can be treated.
Monitoring and Care: After the procedure, the patient's condition is monitored. Typically, a follow-up X-ray or ultrasound is performed to check the results of the procedure.

---

 

Percutaneous Biliary Procedures

Percutaneous biliary procedures encompass interventions performed to address various problems related to the bile ducts. PTC (Percutaneous Transhepatic Cholangiography), often a precursor to these procedures, is integral to the management of diverse biliary issues.

Percutaneous Biliary Drainage:

Necessity: This procedure is indicated when bile accumulation occurs due to a blockage or obstruction in the bile duct.

Procedure: Access to a specific region of the liver is achieved using a needle, and a drainage catheter is placed into the bile ducts. Bile is then drained through this catheter.

---

1. Percutaneous Gallstone Removal (ESWL):

   Necessity: This is used when gallstones need to be removed. This procedure is typically performed in cases where the stones are causing a blockage in the bile duct.

   Procedure: The stones can be broken up or removed through a catheter placed with the aid of imaging.

   Percutaneous Bile Duct Stenting:

   Necessity: This is performed when the bile duct is narrowed or blocked. Stents are placed to maintain the patency (openness) of the bile duct

         Procedure: A thin stent is placed into the narrowed or blocked bile duct. This stent facilitates bile flow and helps prevent obstruction.

---

Complications and Management

Although percutaneous biliary procedures are generally safe, some complications may arise:

• Infection: There is a risk of infection after the procedure. This risk is minimized with sterile techniques and appropriate antibiotic prophylaxis.
• Bleeding: There is a risk of bleeding during or after the procedure. Observation and appropriate hemostatic management are important.
• Organ Damage: There may be a risk of damage to adjacent organs during the procedure. Accurate imaging techniques reduce this risk.
• Drainage Site Problems: Infection or irritation may occur at the drainage site. Wound care and hygiene are important.

Recovery and Follow-up

The recovery process varies depending on the type of procedure and the patient's overall health. Regular monitoring and follow-up of patients after the procedure are important. Generally, patients can return to their normal activities within a few days. The effectiveness of drainage and conditions such as recurrence of bile duct obstruction are evaluated with periodic check-ups.

Conclusion

Percutaneous transhepatic cholangiography (PTC) and other percutaneous biliary procedures are effective minimally invasive procedures that play a significant role in the diagnosis and treatment of abnormalities in the bile ducts. These methods, used for bile duct obstruction, stones, strictures, and other pathologies, increase patient comfort and accelerate the recovery process. Accurate pre- and post-procedure evaluation, the use of appropriate techniques, and careful follow-up reduce the risks of complications and increase treatment success.

This information has been verified with medical information confirmed by specialist physician İbadat Hasanov and aims to inform individuals. In any case, the treatment plan is determined specifically for you, and this decision is meticulously evaluated by your doctors.