Percutaneous Transhepatic Cholangiography (PTHC)

The bile ducts are passages that transport bile in the liver and the gall bladder. X-ray examination of these ducts is sometimes done by PTHC. PTHC is the abbreviation for percutaneous transhepatic cholangiography.

PTHC is used to:

• find cause of pain after gall bladder removal

• tell if jaundice is caused by an obstruction and

• find the site of obstruction

During PTHC, examiners inject a contrast dye into the liver. The test determines if slowed or stopped bile flow is due to a blockage. If not, it is likely due to liver disease. The procedure poses a slight risk of bleeding, infection, and misplaced contrast dye.

The person must fast for 8 hours before the test. During the test, the person lies on an x-ray table that tilts at various angles while the examiner injects a local anesthetic into the liver. A mild sedative may be given. A flexible needle delivers a dye deep in the liver. The examiner watches the dye flow through bile ducts on a fluoroscope. The fluoroscope uses constant x-rays to produce a moving image. Still x-rays also record findings. The test lasts for about 30 minutes. After the test, bed rest is required for at least 6 hours.

Enlarged ducts may indicate a blockage. If ducts are normal size, the healthcare provider may recommend a liver biopsy.

A biopsy of the liver is used to diagnose:

• hepatitis

• cirrhosis

• cancer and

• other liver disease

People who are extremely sensitive to iodine or have severe bleeding disorders should not have PTHC. Past reactions to shellfish may indicate iodine sensitivity. Possible side effects of the contrast dye include nausea, vomiting, flushing, itching, sweating, and salivating. On very rare occasions a person may have an extreme allergic reaction to the contrast dye.

Copyright (c) 1998. HBO & Company (602) 230-7575. All Rights Reserved.