What is a percutaneous transhepatic cholangiogram (PTC)?

A percutaneous transhepatic cholangiogram (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.

The liver and surrounding organs

Why do I need a PTC?

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 place a thin tube (stent) into the bile duct when a cancer is causing a blockage.  

What happens during a PTC?

Doctors will ask you not to eat or drink for a few hours before a PTC. You will have the procedure in the x-ray department. To help prevent infection, you will take antibiotics before and after the PTC. You will probably need to stay in hospital overnight.

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. You may feel some discomfort as the needle enters the liver.

The doctor looks at x-ray images on a screen to help them guide the needle to the bile duct. Once it is in the bile duct, they inject a dye. This helps shows any abnormality or blockages more clearly. When doctor injects the dye, some people feel warm all over. This is normal and the feeling does not last long.

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 cancerinformationteam@macmillan.org.uk

    British Society of Gastroenterology. Guidelines for the management of patients with pancreatic cancer peri-ampullary and ampullary carcinomas. 2005.

    European Society for Medial Oncology. Cancer of the pancreas: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2015. 26 (Supplement 5): v56 to v68.

    Fernandez-del Castillo. Clinical manifestations, diagnosis, and staging of exocrine pancreatic cancer. UpToDate online. Jan 2018.

    Fernandez-del Castillo C, et al. Supportive care of the patient with locally advanced or metastatic exocrine pancreatic cancer. UpToDate online. Feb 2017. 

    Winter JM, et al. Cancer of the pancreas, DeVita Hellman and Rosenberg’s Cancer: Principles and Practice of Oncology (10th edition). Lippincott Williams and Wilkins. 2016.


  • 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 Senior 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.

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