PTC.pptx

Dr. Dheeraj  Kumar
Dr. Dheeraj Kumar Assistant Professor at School of Health Sciences, Chhatrapati Shahu Ji Maharaj University, Kanpur, Uttar-Pradesh
Percutaneous Transhepatic
Cholangiography
Presenter: Dr. Dheeraj Kumar
MRIT, Ph.D. (Radiology and Imaging)
Assistant Professor
Medical Radiology and Imaging Technology
School of Health Sciences, CSJM University, Kanpur
Contents
• Introduction to Percutaneous
Transhepatic Cholangiography
(PTC)
• Indications and Contraindications
• Procedure Overview
• Imaging Technique
• Interpretation of Results
• Advantages and Disadvantages
• Complications and Safety Measures
• Case Studies
• Conclusion
• Questions and Discussion
16/09/2023 PTC By- Dr. Dheeraj Kumar 2
Introduction to Percutaneous Transhepatic
Cholangiography (PTC)
• Definition: Percutaneous
Transhepatic Cholangiography
(PTC) is a radiographic procedure
used to visualize and assess the
biliary system, including the bile
ducts within the liver and those
leading to the small intestine.
16/09/2023 PTC By- Dr. Dheeraj Kumar 3
Anatomy
16/09/2023 PTC By- Dr. Dheeraj Kumar 4
Purpose
• PTC serves several essential purposes in radiography and healthcare:
• Diagnosis and assessment of biliary system disorders.
• Evaluation of bile duct blockages, strictures, or leaks.
• Preoperative planning for biliary surgery.
16/09/2023 PTC By- Dr. Dheeraj Kumar 5
History
• History of PTC reflects the ongoing commitment of radiologists and medical researchers
to refine and expand the capabilities of diagnostic radiology.
• From early experiments with contrast agents to the development of sophisticated
percutaneous techniques, PTC has made a lasting impact on the field of medical imaging
and the diagnosis and treatment of biliary system disorders.
• In recent years, the field of interventional radiology has continued to evolve with the
development of less invasive alternatives like magnetic resonance
cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography
(ERCP).
16/09/2023 PTC By- Dr. Dheeraj Kumar 6
Pioneer Radiologists and Key Milestones
• Dr. Felix Berci: A pioneer in interventional radiology, Dr. Felix Berci
played a pivotal role in advancing PTC techniques in the 1960s and 1970s.
He introduced safer contrast agents and refined percutaneous puncture
methods.
• Dr. Jean-François Gigot: Dr. Gigot further advanced the field by
contributing to the understanding of PTC's diagnostic capabilities and its
role in guiding biliary surgery.
16/09/2023 PTC By- Dr. Dheeraj Kumar 7
Indications
• Suspected Biliary Obstruction: PTC is frequently performed when a patient
presents with symptoms such as jaundice, abdominal pain, or abnormal liver
function tests that may suggest biliary obstruction.
• Evaluation of Biliary Anatomy: It is utilized to obtain detailed information
about the biliary system's anatomy and any associated abnormalities.
• Preoperative Planning: Surgeons may request PTC images to plan surgical
interventions involving the biliary tract.
16/09/2023 PTC By- Dr. Dheeraj Kumar 8
Contraindications
• Allergy to Contrast Media: Individuals with known allergies to iodinated
contrast agents used in PTC should not undergo the procedure.
• Uncontrolled Bleeding Disorders: Patients with severe bleeding disorders
may not be suitable candidates for PTC due to the risk of hemorrhage.
• Severe Coagulopathy: Patients with coagulation disorders or anticoagulant
therapy may require careful consideration and potential adjustment of their
medications.
16/09/2023 PTC By- Dr. Dheeraj Kumar 9
Procedure Overview
• Patient Preparation:
• Consent and Explanation: Informed
consent is obtained from the patient,
and a detailed explanation of the
procedure is provided.
• Fasting Requirements: Patients are
typically instructed to fast for several
hours before the procedure to reduce
the risk of aspiration and ensure
optimal imaging conditions.
16/09/2023 PTC By- Dr. Dheeraj Kumar 10
Localization and Skin Marking
• Identifying the Puncture Site:
Imaging guidance, such as
ultrasound or fluoroscopy, is used
to identify the optimal puncture site
on the patient's abdomen.
• Skin Marking: The chosen puncture
site is marked on the patient's skin
for precise needle placement.
16/09/2023 PTC By- Dr. Dheeraj Kumar 11
Needle Puncture
• Accessing the Biliary System: A
thin, hollow needle is inserted
through the marked site, through
the liver tissue, and into the
biliary system under sterile
conditions and imaging guidance.
16/09/2023 PTC By- Dr. Dheeraj Kumar 12
Contrast Media Injection
• Visualization of the Biliary System:
A radiopaque contrast material is
injected through the needle into the
biliary system.
• Opacification of Ducts: The
contrast material opacifies the bile
ducts, allowing them to be
visualized on X-ray images.
16/09/2023 PTC By- Dr. Dheeraj Kumar 13
Imaging and Documentation
• X-ray or Fluoroscopy: Real-time X-ray images or fluoroscopic images
are captured to visualize the contrast's flow within the bile ducts.
• Static Images: Static images may be taken to document specific
findings or abnormalities.
16/09/2023 PTC By- Dr. Dheeraj Kumar 14
Catheter Placement
• Extended Contrast Injection
or Drainage: In some
cases, a catheter may be left
in place to facilitate
extended contrast injection,
drainage of bile, or
therapeutic interventions.
16/09/2023 PTC By- Dr. Dheeraj Kumar 15
Imaging Technique
• Radiographic Equipment:
• Fluoroscopy or X-ray Machine: PTC is
typically performed using fluoroscopy or
X-ray equipment to capture real-time and
static images.
• Image Intensifier: Fluoroscopy often
employs an image intensifier to enhance
image quality and reduce radiation
exposure.
16/09/2023 PTC By- Dr. Dheeraj Kumar 16
Contrast Media Characteristics
• Radiopaque Properties: The
contrast media used in PTC has
radiopaque properties, making
it visible on X-ray images.
• Opacification of Bile Ducts: It
selectively opacifies the bile
ducts, enhancing their visibility.
16/09/2023 PTC By- Dr. Dheeraj Kumar 17
Timing and Image Sequence
• Real-time Imaging: Real-time
fluoroscopy allows continuous
monitoring of the contrast flow during
injection.
• Static Images: Static X-ray images
are taken at specific points to
document findings and provide
detailed anatomical information.
16/09/2023 PTC By- Dr. Dheeraj Kumar 18
Interpretation of Results
Normal vs. Abnormal Findings:
• Normal Bile Duct Anatomy: In a normal PTC, the radiologist observes well-defined
bile ducts with a characteristic branching pattern.
• Identification of Abnormalities: PTC is invaluable for identifying various
abnormalities, including:
• Bile Duct Blockages: The procedure can pinpoint the location and extent of blockages caused
by factors like gallstones or tumors.
• Biliary Strictures: Narrowing or strictures in the bile ducts can be precisely identified.
• Biliary Leaks: PTC can detect leaks in the biliary system, often as a result of injury or surgery.
16/09/2023 PTC By- Dr. Dheeraj Kumar 19
Radiologist's Role
• Image Analysis: Radiologists play a central role in interpreting PTC
results. They analyze the images, identify abnormalities, and provide
detailed reports.
• Collaboration with Healthcare Team: Radiologists collaborate closely
with surgeons, gastroenterologists, and other healthcare professionals
to determine the best course of treatment based on the PTC findings.
16/09/2023 PTC By- Dr. Dheeraj Kumar 20
Advantages
• Direct Visualization: PTC provides direct visualization of the biliary
system, offering precise anatomical information.
• Diagnostic Precision: It is highly effective in diagnosing a wide range
of biliary conditions, guiding treatment decisions.
• Minimally Invasive: PTC is less invasive than surgical exploration and
can often replace more invasive procedures.
16/09/2023 PTC By- Dr. Dheeraj Kumar 21
Disadvantages
• Invasive Nature: PTC is an invasive procedure, involving percutaneous
access to the liver, which carries inherent risks.
• Risk of Complications: There is a risk of complications such as bleeding,
infection, or bile leakage, although these are relatively uncommon.
• Limited Therapeutic Role: While PTC is primarily diagnostic, it may also
guide some therapeutic interventions. However, it may not be suitable for
all cases or therapeutic purposes.
16/09/2023 PTC By- Dr. Dheeraj Kumar 22
Potential Complications
• Bleeding: PTC may lead to bleeding at the puncture site or within the
liver.
• Infection: Infection is a possible complication, although strict sterile
techniques are employed to minimize this risk.
• Perforation: Rarely, there may be unintended perforation of structures
within the liver or bile ducts.
16/09/2023 PTC By- Dr. Dheeraj Kumar 23
Safety Measures
• Sterile Technique: PTC is performed under strict sterile conditions to reduce
the risk of infection.
• Monitoring: Patients are closely monitored during and after the procedure to
detect and manage complications promptly.
• Preventive Measures: Care is taken to minimize bleeding risks, including
assessment of coagulation status, and correction of coagulopathies when
necessary.
16/09/2023 PTC By- Dr. Dheeraj Kumar 24
Case Studies
• Case 1: Biliary
Obstruction: Detail a
case where PTC
identified a biliary
obstruction, leading to a
diagnosis and treatment
plan.
16/09/2023 PTC By- Dr. Dheeraj Kumar 25
Case 2: Biliary Stricture
• Present a scenario
involving a biliary
stricture,
demonstrating how
PTC can precisely
locate and
characterize the
stricture.
16/09/2023 PTC By- Dr. Dheeraj Kumar 26
Case 3: Complications and Management
• Discuss a case
where complications
arose during PTC
and describe the
appropriate
management and
intervention.
16/09/2023 PTC By- Dr. Dheeraj Kumar 27
Conclusion
• The diagnostic significance of PTC in evaluating biliary system disorders.
• Indications and contraindications for the procedure.
• The procedure overview, including patient preparation, needle puncture, contrast media injection,
and imaging techniques.
• The role of radiologists in interpreting PTC results.
• Advantages, disadvantages, and safety considerations.
• Potential complications and safety measures.
• Real-world case studies showcasing the diagnostic and therapeutic utility of PTC.
16/09/2023 PTC By- Dr. Dheeraj Kumar 28
Questions and Discussion
Open the Floor for Questions? and Discussion @@
16/09/2023 PTC By- Dr. Dheeraj Kumar 29
Thank You
Express gratitude to the Students for their active participation, attention, and
contributions during the presentation.
16/09/2023 PTC By- Dr. Dheeraj Kumar 30
References
• "Radiologic Science for Technologists: Physics, Biology, and Protection"Authors: Stewart C.
Bushong, Publication Year: 2019, Publisher: Elsevier
• "Interventional Radiology Procedures in Biopsy and Drainage“, Authors: Ronald S. Arellano, Aldo
A. Maksoud,Publication Year: 2020, Publisher: Springer
• "Percutaneous Transhepatic Cholangiography: Techniques and Applications“,Authors: C. Christian,
H. Weismann, S. Dengler, et al.,Publication Year: 2021
• "Complications of Percutaneous Transhepatic Cholangiography in the Management of Postsurgical
Biliary Leaks and Strictures“, Authors: Arno NK Joseph, Peter Thuluvath, Publication Year: 2020
16/09/2023 PTC By- Dr. Dheeraj Kumar 31
1 of 31

More Related Content

What's hot(20)

Physical Principle of MRI.pptxPhysical Principle of MRI.pptx
Physical Principle of MRI.pptx
Dr. Dheeraj Kumar 100 views
Guidelines for X-Ray Equipments.pptxGuidelines for X-Ray Equipments.pptx
Guidelines for X-Ray Equipments.pptx
Dr. Dheeraj Kumar 138 views
Catheter and Guidewire.pptxCatheter and Guidewire.pptx
Catheter and Guidewire.pptx
Dr. Dheeraj Kumar 240 views
Emergency in Radiology Department.pptxEmergency in Radiology Department.pptx
Emergency in Radiology Department.pptx
Dr. Dheeraj Kumar 498 views
RGU.pptxRGU.pptx
RGU.pptx
Dr. Dheeraj Kumar 207 views
Computed Tomography Equipments.pptxComputed Tomography Equipments.pptx
Computed Tomography Equipments.pptx
Dr. Dheeraj Kumar 344 views
History of Ultrasound Imaging.pptxHistory of Ultrasound Imaging.pptx
History of Ultrasound Imaging.pptx
Dr. Dheeraj Kumar 577 views
Principle of Ultrasound.pptxPrinciple of Ultrasound.pptx
Principle of Ultrasound.pptx
Dr. Dheeraj Kumar 102 views
Radiographic Exposure.pptxRadiographic Exposure.pptx
Radiographic Exposure.pptx
Dr. Dheeraj Kumar 228 views
Intensifying Screen.pptxIntensifying Screen.pptx
Intensifying Screen.pptx
Dr. Dheeraj Kumar 204 views
X-Ray Properties.pptxX-Ray Properties.pptx
X-Ray Properties.pptx
Dr. Dheeraj Kumar 846 views
SPECT with clinical application SPECT with clinical application
SPECT with clinical application
عبدالله فهد5.9K views
Radiographic Grid.pptxRadiographic Grid.pptx
Radiographic Grid.pptx
Dr. Dheeraj Kumar 185 views
X-ray production AND Emission.pptxX-ray production AND Emission.pptx
X-ray production AND Emission.pptx
Dr. Dheeraj Kumar 139 views
Radiographic Latent Image .pptxRadiographic Latent Image .pptx
Radiographic Latent Image .pptx
Dr. Dheeraj Kumar 172 views
 contrast medium  contrast medium
contrast medium
drgm_sudip877 views

Similar to PTC.pptx(20)

4.Abdominal trauma.pptx4.Abdominal trauma.pptx
4.Abdominal trauma.pptx
myLord36 views
5_6125448697896502767.pptx5_6125448697896502767.pptx
5_6125448697896502767.pptx
DeepshikhaKar110 views
CTO vs Medical managementCTO vs Medical management
CTO vs Medical management
Pavan Rasalkar417 views
Antibiotics Prophylaxis in genitourinary surgeryAntibiotics Prophylaxis in genitourinary surgery
Antibiotics Prophylaxis in genitourinary surgery
GovtRoyapettahHospit155 views
CCCR.pptxCCCR.pptx
CCCR.pptx
TekiyMarkos160 views
Investigation of Biliary Tract Investigation of Biliary Tract
Investigation of Biliary Tract
Sujan Poudel1.2K views
Investigation of Biliary Tract Investigation of Biliary Tract
Investigation of Biliary Tract
Scholars of Medical Imaging BPKIHS Dharan383 views
Biliary drainageBiliary drainage
Biliary drainage
Dr. Yash Kumar Achantani3.2K views
BILE DUCT INJURY 09-05.pptBILE DUCT INJURY 09-05.ppt
BILE DUCT INJURY 09-05.ppt
RubnDarioRojasChica4 views
GIT J Club ercp mistakes UEG.GIT J Club ercp mistakes UEG.
GIT J Club ercp mistakes UEG.
Case records of Sulaymaniah General Teaching Hospital.408 views
CT urography CT urography
CT urography
SabitaMandal18.9K views

More from Dr. Dheeraj Kumar (7)

FILM PROCESSING AND DEVELOPMENT.pptxFILM PROCESSING AND DEVELOPMENT.pptx
FILM PROCESSING AND DEVELOPMENT.pptx
Dr. Dheeraj Kumar 112 views
Physical Principle of Ultrasound.pptxPhysical Principle of Ultrasound.pptx
Physical Principle of Ultrasound.pptx
Dr. Dheeraj Kumar 61 views
Radiographic Film.pptxRadiographic Film.pptx
Radiographic Film.pptx
Dr. Dheeraj Kumar 447 views
 anatomy of general gynecology.pptx anatomy of general gynecology.pptx
anatomy of general gynecology.pptx
Dr. Dheeraj Kumar 32 views
X-ray Interaction with Matter.pptxX-ray Interaction with Matter.pptx
X-ray Interaction with Matter.pptx
Dr. Dheeraj Kumar 318 views

Recently uploaded(20)

Torque in orthodontics.docxTorque in orthodontics.docx
Torque in orthodontics.docx
Dr.Mohammed Alruby8 views
HYDROCOLLATOR PACK by Dr. Aneri.pptxHYDROCOLLATOR PACK by Dr. Aneri.pptx
HYDROCOLLATOR PACK by Dr. Aneri.pptx
AneriPatwari106 views
INDIAN SYSTEM OF MEDICINE, UNIT1, MPHARM PCG SEM2.pptxINDIAN SYSTEM OF MEDICINE, UNIT1, MPHARM PCG SEM2.pptx
INDIAN SYSTEM OF MEDICINE, UNIT1, MPHARM PCG SEM2.pptx
Prithivirajan Senthilkumar15 views
Anaemia,jaundice.pptxAnaemia,jaundice.pptx
Anaemia,jaundice.pptx
Reena Gollapalli14 views
CRANIAL NERVE EXAMINATION.pptxCRANIAL NERVE EXAMINATION.pptx
CRANIAL NERVE EXAMINATION.pptx
Nerusu sai priyanka111 views
Pregnancy tips.pptxPregnancy tips.pptx
Pregnancy tips.pptx
reachout734 views
Referral-system_April-2023.pdfReferral-system_April-2023.pdf
Referral-system_April-2023.pdf
manali905434 views
MEDICAL RESEARCH.pptxMEDICAL RESEARCH.pptx
MEDICAL RESEARCH.pptx
rishi278942 views
melani glossophobia.pdfmelani glossophobia.pdf
melani glossophobia.pdf
Paygeon8 views
POWDERS.pptxPOWDERS.pptx
POWDERS.pptx
SUJITHA MARY10 views
Allergy Shots - BasicsAllergy Shots - Basics
Allergy Shots - Basics
lesliemspeer7 views
EpileptogenesisEpileptogenesis
Epileptogenesis
Vamsi Krishna Koneru8 views
NMP-6.pptxNMP-6.pptx
NMP-6.pptx
Sai Sailesh Kumar Goothy41 views

PTC.pptx

  • 1. Percutaneous Transhepatic Cholangiography Presenter: Dr. Dheeraj Kumar MRIT, Ph.D. (Radiology and Imaging) Assistant Professor Medical Radiology and Imaging Technology School of Health Sciences, CSJM University, Kanpur
  • 2. Contents • Introduction to Percutaneous Transhepatic Cholangiography (PTC) • Indications and Contraindications • Procedure Overview • Imaging Technique • Interpretation of Results • Advantages and Disadvantages • Complications and Safety Measures • Case Studies • Conclusion • Questions and Discussion 16/09/2023 PTC By- Dr. Dheeraj Kumar 2
  • 3. Introduction to Percutaneous Transhepatic Cholangiography (PTC) • Definition: Percutaneous Transhepatic Cholangiography (PTC) is a radiographic procedure used to visualize and assess the biliary system, including the bile ducts within the liver and those leading to the small intestine. 16/09/2023 PTC By- Dr. Dheeraj Kumar 3
  • 4. Anatomy 16/09/2023 PTC By- Dr. Dheeraj Kumar 4
  • 5. Purpose • PTC serves several essential purposes in radiography and healthcare: • Diagnosis and assessment of biliary system disorders. • Evaluation of bile duct blockages, strictures, or leaks. • Preoperative planning for biliary surgery. 16/09/2023 PTC By- Dr. Dheeraj Kumar 5
  • 6. History • History of PTC reflects the ongoing commitment of radiologists and medical researchers to refine and expand the capabilities of diagnostic radiology. • From early experiments with contrast agents to the development of sophisticated percutaneous techniques, PTC has made a lasting impact on the field of medical imaging and the diagnosis and treatment of biliary system disorders. • In recent years, the field of interventional radiology has continued to evolve with the development of less invasive alternatives like magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP). 16/09/2023 PTC By- Dr. Dheeraj Kumar 6
  • 7. Pioneer Radiologists and Key Milestones • Dr. Felix Berci: A pioneer in interventional radiology, Dr. Felix Berci played a pivotal role in advancing PTC techniques in the 1960s and 1970s. He introduced safer contrast agents and refined percutaneous puncture methods. • Dr. Jean-François Gigot: Dr. Gigot further advanced the field by contributing to the understanding of PTC's diagnostic capabilities and its role in guiding biliary surgery. 16/09/2023 PTC By- Dr. Dheeraj Kumar 7
  • 8. Indications • Suspected Biliary Obstruction: PTC is frequently performed when a patient presents with symptoms such as jaundice, abdominal pain, or abnormal liver function tests that may suggest biliary obstruction. • Evaluation of Biliary Anatomy: It is utilized to obtain detailed information about the biliary system's anatomy and any associated abnormalities. • Preoperative Planning: Surgeons may request PTC images to plan surgical interventions involving the biliary tract. 16/09/2023 PTC By- Dr. Dheeraj Kumar 8
  • 9. Contraindications • Allergy to Contrast Media: Individuals with known allergies to iodinated contrast agents used in PTC should not undergo the procedure. • Uncontrolled Bleeding Disorders: Patients with severe bleeding disorders may not be suitable candidates for PTC due to the risk of hemorrhage. • Severe Coagulopathy: Patients with coagulation disorders or anticoagulant therapy may require careful consideration and potential adjustment of their medications. 16/09/2023 PTC By- Dr. Dheeraj Kumar 9
  • 10. Procedure Overview • Patient Preparation: • Consent and Explanation: Informed consent is obtained from the patient, and a detailed explanation of the procedure is provided. • Fasting Requirements: Patients are typically instructed to fast for several hours before the procedure to reduce the risk of aspiration and ensure optimal imaging conditions. 16/09/2023 PTC By- Dr. Dheeraj Kumar 10
  • 11. Localization and Skin Marking • Identifying the Puncture Site: Imaging guidance, such as ultrasound or fluoroscopy, is used to identify the optimal puncture site on the patient's abdomen. • Skin Marking: The chosen puncture site is marked on the patient's skin for precise needle placement. 16/09/2023 PTC By- Dr. Dheeraj Kumar 11
  • 12. Needle Puncture • Accessing the Biliary System: A thin, hollow needle is inserted through the marked site, through the liver tissue, and into the biliary system under sterile conditions and imaging guidance. 16/09/2023 PTC By- Dr. Dheeraj Kumar 12
  • 13. Contrast Media Injection • Visualization of the Biliary System: A radiopaque contrast material is injected through the needle into the biliary system. • Opacification of Ducts: The contrast material opacifies the bile ducts, allowing them to be visualized on X-ray images. 16/09/2023 PTC By- Dr. Dheeraj Kumar 13
  • 14. Imaging and Documentation • X-ray or Fluoroscopy: Real-time X-ray images or fluoroscopic images are captured to visualize the contrast's flow within the bile ducts. • Static Images: Static images may be taken to document specific findings or abnormalities. 16/09/2023 PTC By- Dr. Dheeraj Kumar 14
  • 15. Catheter Placement • Extended Contrast Injection or Drainage: In some cases, a catheter may be left in place to facilitate extended contrast injection, drainage of bile, or therapeutic interventions. 16/09/2023 PTC By- Dr. Dheeraj Kumar 15
  • 16. Imaging Technique • Radiographic Equipment: • Fluoroscopy or X-ray Machine: PTC is typically performed using fluoroscopy or X-ray equipment to capture real-time and static images. • Image Intensifier: Fluoroscopy often employs an image intensifier to enhance image quality and reduce radiation exposure. 16/09/2023 PTC By- Dr. Dheeraj Kumar 16
  • 17. Contrast Media Characteristics • Radiopaque Properties: The contrast media used in PTC has radiopaque properties, making it visible on X-ray images. • Opacification of Bile Ducts: It selectively opacifies the bile ducts, enhancing their visibility. 16/09/2023 PTC By- Dr. Dheeraj Kumar 17
  • 18. Timing and Image Sequence • Real-time Imaging: Real-time fluoroscopy allows continuous monitoring of the contrast flow during injection. • Static Images: Static X-ray images are taken at specific points to document findings and provide detailed anatomical information. 16/09/2023 PTC By- Dr. Dheeraj Kumar 18
  • 19. Interpretation of Results Normal vs. Abnormal Findings: • Normal Bile Duct Anatomy: In a normal PTC, the radiologist observes well-defined bile ducts with a characteristic branching pattern. • Identification of Abnormalities: PTC is invaluable for identifying various abnormalities, including: • Bile Duct Blockages: The procedure can pinpoint the location and extent of blockages caused by factors like gallstones or tumors. • Biliary Strictures: Narrowing or strictures in the bile ducts can be precisely identified. • Biliary Leaks: PTC can detect leaks in the biliary system, often as a result of injury or surgery. 16/09/2023 PTC By- Dr. Dheeraj Kumar 19
  • 20. Radiologist's Role • Image Analysis: Radiologists play a central role in interpreting PTC results. They analyze the images, identify abnormalities, and provide detailed reports. • Collaboration with Healthcare Team: Radiologists collaborate closely with surgeons, gastroenterologists, and other healthcare professionals to determine the best course of treatment based on the PTC findings. 16/09/2023 PTC By- Dr. Dheeraj Kumar 20
  • 21. Advantages • Direct Visualization: PTC provides direct visualization of the biliary system, offering precise anatomical information. • Diagnostic Precision: It is highly effective in diagnosing a wide range of biliary conditions, guiding treatment decisions. • Minimally Invasive: PTC is less invasive than surgical exploration and can often replace more invasive procedures. 16/09/2023 PTC By- Dr. Dheeraj Kumar 21
  • 22. Disadvantages • Invasive Nature: PTC is an invasive procedure, involving percutaneous access to the liver, which carries inherent risks. • Risk of Complications: There is a risk of complications such as bleeding, infection, or bile leakage, although these are relatively uncommon. • Limited Therapeutic Role: While PTC is primarily diagnostic, it may also guide some therapeutic interventions. However, it may not be suitable for all cases or therapeutic purposes. 16/09/2023 PTC By- Dr. Dheeraj Kumar 22
  • 23. Potential Complications • Bleeding: PTC may lead to bleeding at the puncture site or within the liver. • Infection: Infection is a possible complication, although strict sterile techniques are employed to minimize this risk. • Perforation: Rarely, there may be unintended perforation of structures within the liver or bile ducts. 16/09/2023 PTC By- Dr. Dheeraj Kumar 23
  • 24. Safety Measures • Sterile Technique: PTC is performed under strict sterile conditions to reduce the risk of infection. • Monitoring: Patients are closely monitored during and after the procedure to detect and manage complications promptly. • Preventive Measures: Care is taken to minimize bleeding risks, including assessment of coagulation status, and correction of coagulopathies when necessary. 16/09/2023 PTC By- Dr. Dheeraj Kumar 24
  • 25. Case Studies • Case 1: Biliary Obstruction: Detail a case where PTC identified a biliary obstruction, leading to a diagnosis and treatment plan. 16/09/2023 PTC By- Dr. Dheeraj Kumar 25
  • 26. Case 2: Biliary Stricture • Present a scenario involving a biliary stricture, demonstrating how PTC can precisely locate and characterize the stricture. 16/09/2023 PTC By- Dr. Dheeraj Kumar 26
  • 27. Case 3: Complications and Management • Discuss a case where complications arose during PTC and describe the appropriate management and intervention. 16/09/2023 PTC By- Dr. Dheeraj Kumar 27
  • 28. Conclusion • The diagnostic significance of PTC in evaluating biliary system disorders. • Indications and contraindications for the procedure. • The procedure overview, including patient preparation, needle puncture, contrast media injection, and imaging techniques. • The role of radiologists in interpreting PTC results. • Advantages, disadvantages, and safety considerations. • Potential complications and safety measures. • Real-world case studies showcasing the diagnostic and therapeutic utility of PTC. 16/09/2023 PTC By- Dr. Dheeraj Kumar 28
  • 29. Questions and Discussion Open the Floor for Questions? and Discussion @@ 16/09/2023 PTC By- Dr. Dheeraj Kumar 29
  • 30. Thank You Express gratitude to the Students for their active participation, attention, and contributions during the presentation. 16/09/2023 PTC By- Dr. Dheeraj Kumar 30
  • 31. References • "Radiologic Science for Technologists: Physics, Biology, and Protection"Authors: Stewart C. Bushong, Publication Year: 2019, Publisher: Elsevier • "Interventional Radiology Procedures in Biopsy and Drainage“, Authors: Ronald S. Arellano, Aldo A. Maksoud,Publication Year: 2020, Publisher: Springer • "Percutaneous Transhepatic Cholangiography: Techniques and Applications“,Authors: C. Christian, H. Weismann, S. Dengler, et al.,Publication Year: 2021 • "Complications of Percutaneous Transhepatic Cholangiography in the Management of Postsurgical Biliary Leaks and Strictures“, Authors: Arno NK Joseph, Peter Thuluvath, Publication Year: 2020 16/09/2023 PTC By- Dr. Dheeraj Kumar 31