Percutaneous Transhepatic Cholangi... Health Article

Definition

Percutaneous transhepatic cholangiography (PTHC) is an x-ray test used to identify obstructions either in the liver or bile ducts that slow or stop the flow of bile from the liver to the digestive system.

Purpose

Because the liver and bile ducts are not normally seen on x-rays, the doctor injects the liver with a special dye that will show up on the resulting picture. This dye distributes evenly to fill the whole liver drainage system. If the dye does not distribute evenly, this is indicative of a blockage, which may caused by a gallstone or a tumor in the liver, bile ducts, or pancreas.

Precautions

Patients should report allergic reactions to:

• anesthetics
• dyes used in medical tests
• iodine
• shellfish

PTHC should not be performed on anyone who has cholangitis (inflammation of the bile duct), massive ascites, a severe allergy to iodine, or a serious uncorrectable or uncontrollable bleeding disorder. Patients who have diabetes should inform their doctor.

Description

PTHC is performed in a hospital, doctor's office, or outpatient surgical or x-ray facility. The patient lies on a movable x-ray table and is given a local anesthetic. The patient will be told to hold his or her breath, and a doctor, nurse, or laboratory technician will inject a special dye into the liver as the patient exhales.

The patient may feel a twinge when the needle penetrates the liver, a pressure or fullness, or brief discomfort in the upper right side of the back. Hands and feet may become numb during the 30-60 minute procedure.

The x-ray table will be rotated several times during the test, and the patient helped to assume a variety of positions. A special x-ray machine called a fluoroscope will track the dye's movement through the bile ducts and show whether the fluid is moving freely or if its passage is obstructed.

PTHC costs about $1, 600. The test may have to be repeated if the patient moves while x rays are being taken.