Percutaneous transhepatic cholangiogram

Percutaneous transhepatic cholangiogram (PTC)

What is percutaneous transhepatic cholangiogram (PTC)?

Percutaneous transhepatic cholangiogram (PTC) is a radiologic procedure used to examine the liver, gallbladder, and bile ducts. During this procedure, contrast material is injected into the liver through the skin followed by careful X-ray images. The contrast material enables the radiologist to better visualize the bile ducts, fill any defects, and perform any necessary therapeutic procedures.


Before the procedure, your doctor will perform a physical exam and discuss your medical history. It is important to let your doctor know if you are allergic to any medications or contrast materials. You may need to stop taking certain medications before the procedure. You should also inform your doctor if you are pregnant or might be pregnant.


PTC is a minimally invasive procedure and is usually done on an outpatient basis in the radiology suite or in the operating room. During the procedure, an anesthesiologist or nurse anesthetist will administer a sedative or anesthetic to make you drowsy or put you to sleep. You will also be positioned on the X-ray table and the area on your skin where the catheter will be inserted will be cleaned and draped. An X-ray image will then be taken to determine the best place to insert the catheter.

A small incision will then be made in the skin and the catheter will be inserted. The radiologist will then inject contrast material into the catheter and take X-ray images to enable visualization of the bile ducts. A thin plastic tube may be placed in the catheter as well to allow injection of contrast material and to drain any fluids from the ducts. Once the procedure is completed, the catheter will be removed and the incision will be closed.


There are two types of percutaneous transhepatic cholangiogram: direct and indirect. Direct PTC involves directly inserting the catheter into the liver, while indirect PTC involves inserting the catheter through an endoscope placed in the bile duct.


PTC is generally a safe and effective procedure. However, as with any procedure, there are risks associated with PTC. These risks include infection, bleeding, allergic reaction to the contrast material, and possible damage to the liver or other organs. Your doctor will discuss the risks and benefits of PTC with you prior to the procedure.

Why is this procedure performed?

PTC is usually performed to help diagnose and treat various conditions related to the liver, gallbladder, and bile ducts. These conditions may include bile duct blockage, tumors, gallstones, or abscesses. PTC can also be used to relieve symptoms associated with these conditions such as pain, jaundice, or an enlarged liver.

When is a percutaneous transhepatic cholangiogram performed?

A PTC is usually performed after other imaging tests have been done and no other treatment options are available. Your doctor will determine when a PTC is appropriate for your condition.