Percutaneous transhepatic cholangiography, also known as PTC, is a method of cholangiography. This method is currently mainly used for patients with obstructive jaundice. The examination can be used to understand the location, extent and cause of biliary obstruction, which can help surgeons choose appropriate surgical methods and procedures. Mainly used in patients with obstructive jaundice to understand the location, extent and cause of biliary obstruction.

Basic Information

Specialist classification: Digestive examination classification: X-ray

Applicable gender: whether men and women apply fasting: not fasting

Tips: Do not eat within 12 hours after the examination, pay attention to changes in blood pressure, pulse, etc., and whether there is abdominal pain, etc., as well as early detection of intra-abdominal hemorrhage and biliary peritonitis, and do the corresponding treatment. Normal value

PTC can clearly show the morphology and structure of intrahepatic and extrahepatic bile ducts, and can be used to diagnose diseases of the biliary system by analyzing the images of bile ducts.

Clinical significance

Mainly used in patients with obstructive jaundice to understand the location, extent and cause of biliary obstruction.

PTC is the best way to diagnose intrahepatic bile duct stones and bile duct stricture. The technique is simpler, the success rate is up to 96.45%, and the complications are few. The overall relationship between the stone and the diseased bile duct can be clearly displayed, and the whole appearance of the intrahepatic bile duct stone, stenosis and dilation is fully displayed. If the main branch of a hepatic bile duct is not developed, it can be added as a selective PTC under the guidance of B-ultrasound. PTC images can provide an important basis for hepatolithiasis classification, preoperative discussion, and surgical options, especially right intrahepatic bile duct stones.

Precautions

Before the examination: first, blood tests should be performed to check the platelet count, prothrombin time and clotting time, etc. If there is abnormality, the corresponding treatment should be done first; the hemostatic drug such as vitamin K should be injected every day before the examination; the patient with fever should first Treatment with antibiotics such as ampicillin or gentamicin; before the examination, the patient should be tested for iodine allergy as if he had venous cholangiography. The test may be negative for examination; do not eat breakfast or drinking water on the morning of the test.

When checking: Don't be nervous, as long as you work closely with your doctor, there is generally no danger. When the doctor pierces the needle into the liver, the patient temporarily holds the gas. When the doctor injects the contrast agent, the patient should not breathe hard, try to keep the breathing evenly. Do not take deep breath or cough, etc., otherwise the puncture needle will slide out of the bile duct and the contrast will fail.

After the examination: can not eat within 12 hours; pay attention to changes in blood pressure, pulse, etc. and the presence or absence of abdominal pain, as well as early detection of intra-abdominal hemorrhage and biliary peritonitis, and do the corresponding treatment.

Contraindications: (1) Those with positive iodine allergy tests. (2) There is a significant bleeding tendency, prothrombin time is significantly prolonged, after the injection of vitamin K is still more than 3 seconds longer than the normal control value, or platelets below 40 × 109 / L. (3) Liver and kidney failure, or a large number of ascites.

Inspection process

Under the surveillance of X-ray TV fluorescence image enhancement, a small amount of local anesthetic is injected into the skin of the chest or abdomen, and a special needle is inserted into the liver. When the needle is inserted into the intrahepatic bile duct, The X-ray contrast agent is injected into the puncture needle, and the image of the bile duct inside and outside the liver can be seen through the TV screen, and then the film is examined.

Not suitable for the crowd

There are no special taboos.

Adverse reactions and risks

Nothing.