Percutaneous transhepatic cholangiogram (PTC)
A PTC is a test that uses x-rays to look at the bile duct. The bile duct is a tube that drains bile out of the liver and into the small bowel.
What is a PTC?
You may have a PTC to help diagnose cancers such as bile duct cancer and gall bladder cancer.
A PTC can also be used to unblock bile ducts and help with jaundice.
The doctor uses a needle and tube to insert a stent through the skin (percutaneously) and liver (transhepatically). They place the stent into the top of the bile duct.
The liver and surrounding organs
Before a PTC
Doctors will ask you not to eat or drink for a few hours before a PTC. To help prevent infection, you will take antibiotics before and after the PTC. You will have the test in the x-ray department. A doctor called an interventional radiologist will do it.
You usually have a PTC as an inpatient in hospital. You may need to stay in hospital for 1 or 2 nights. Some people have it as a day patient.
What happens during a PTC?
Once you are lying down, you will have a sedative to make you feel relaxed and drowsy. You might have a PTC under a general anaesthetic. This means you will be asleep.
After you have had the sedative, the doctor injects a local anaesthetic into the skin to numb the area. Then they insert a needle through the skin and into the liver. The doctor looks at x-ray or ultrasound images on a screen to help them guide the needle to the bile duct.
Once the needle is in the bile duct, the doctor injects a dye. The dye flows through the bile ducts and allows doctors to see the blocked area. If there is a blockage, the doctor inserts a stent. They pass a fine guide wire inside the needle into the blockage. They pass a stent along this wire to hold the bile duct open. This allows bile to flow through it again.
You may feel some pushing when doctors put the wire and stent in. If this is uncomfortable or painful, let the doctor know. They can give you painkillers.
During a PTC, your doctor may put a drainage tube (catheter) in the bile duct first. This can help the doctor insert the stent. One end of the tube is in the bile duct and the other end stays outside the body. It connects to a bag that collects the bile. Doctors usually leave this drainage tube in for a few days. Once they remove it, the area heals in 2 to 3 days.
After a PTC
After the PTC, the nurses will check the area and monitor your blood pressure and pulse.
If you have a drainage bag, the nurses will empty the bag if needed. Your doctor will tell you how long the drain needs to be in place.
The symptoms of jaundice will improve as the blockage is relieved or the bile is allowed to drain.
Possible risks of a PTC
There are not usually serious complications with a PTC. Your doctor or nurse will explain the possible risks. These include:
- bleeding
- infection
- the catheter getting blocked, moving out of position or leaking.
It is important to contact the hospital straight away if you:
- feel unwell
- have possible symptoms of infection
- have any bleeding or leakage.
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our PTC information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Sarwar A. Percutaneous transhepatic cholangiography in adults. Uptodate. Available at www.uptodate.com (subscription only) [accessed May 2023]
Vogel, A. et al. Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Annals of Oncology. 2022. 34,2; 127-140. Available at: pubmed.ncbi.nlm.nih.gov/36372281/ [accessed March 2023]
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