Percutaneous transhepatic cholangiogram (PTC)

Some people with early-stage pancreatic cancer have surgery to remove the cancer. Some people have surgery to relieve symptoms. You may also have surgery to relieve symptoms if the cancer is blocking the bile duct or the bowel.

What is a percutaneous transhepatic cholangiogram (PTC)?

A percutaneous transhepatic cholangiogram (PTC) is a procedure 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.


The liver and surrounding organs
Image: The liver and surrounding organs


The doctor uses a needle and tube to insert a stent through the skin (percutaneous) and liver (transhepatic). They then place the stent into the top of the bile duct.

You may have this procedure to help diagnose cancer. For example, it may be used as a test for bile duct cancer or gall bladder cancer. A PTC can also be used to unblock the bile duct and help with jaundice.

What happens during 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 procedure in the x-ray department. A doctor called a radiologist will do the procedure.

Once you are lying down, you will have a sedative to make you feel relaxed and drowsy. The doctor injects a local anaesthetic into the skin to numb it. Then they insert a long, thin, flexible needle through the skin and into the liver. The doctor looks at x-ray images on a screen to help them guide the needle to the bile duct.

Once the needle is in the bile duct, they inject a dye. When doctor injects the dye, some people feel warm all over. This is normal and the feeling does not last long.

The dye flows through the ducts and allows doctors to see the blocked area. The doctor passes a fine guide wire along the needle into the blockage in the bile duct. The doctor then passes a stent along this wire. The stent holds the bile duct open where the blockage has narrowed it. 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. You will probably need to stay in hospital overnight.

About our information

  • References

    Below is a sample of the sources used in our pancreatic cancer information. If you would like more information about the sources we use, please contact us at

    European Society for Medical Oncology, Cancer of the pancreas: ESMO clinical Practice Guidelines. Volume 26, Supplement 5, V56-V68, 1 September 2015. Available from: (accessed May 2021).

    National Institute for Health and Care Excellence. Pancreatic cancer in adults: diagnosis and management. NICE guideline (NG85). Published 7 February 2018. Available at: (accessed May 2021).

  • Reviewers

    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. It has been approved by Chief Medical Editor, Professor Tim Iveson, Consultant Medical Oncologist.

    Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

Date reviewed

Reviewed: 05 January 2022
Next review: 05 January 2025
Trusted Information Creator - Patient Information Forum
Trusted Information Creator - Patient Information Forum

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