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PTC & PTBD
Dr Nikrish S Hegde
PTC
• PTC, is a way of examining the bile duct system
in the liver.A thin needle is inserted through
the skin (percutaneou...
PTBD
• A Percutaneous Transhepatic Biliary Drainage
is a percutaneous therapeutic procedure
which leads to the drainage of...
Indications
• Biliary Stones
• Biliary Strictures

• Malignancy – pancreas,lymph nodes
• Undiagnosed Jaundice
Contraindication
• Sepsis
• Bleeding Disorders

• Contrast Hypersensitivity
Preparation & procedure
• US/CT prior to PTBD, which provides useful
information regarding the level of obstruction.
• The...
• It is not allowed to eat for four hours before the
examination, but one may drink clear fluids.
• Patient will be given ...
• Monitoring equipment will be attached; this
will measure the blood pressure, heart rate
and oxygen saturation.

• The sk...
• Once the area is numb, the doctor will insert a thin
needle through your skin, between the ribs,
through the liver, into...
Complications
• PAIN
• INFECTIONS

• BLEEDING
• The blood pressure and pulse will be monitored.
• The Haematocrit will be checked.
• The catheter site will be checked f...
PTBD
PTBD
PTBD
PTBD
PTBD
PTBD
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PTBD

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PTBD

  1. 1. PTC & PTBD Dr Nikrish S Hegde
  2. 2. PTC • PTC, is a way of examining the bile duct system in the liver.A thin needle is inserted through the skin (percutaneous) and through the liver (transhepatic) into a bile duct. Then dye is injected, and the bile duct system is outlined on x-rays (cholangiography).
  3. 3. PTBD • A Percutaneous Transhepatic Biliary Drainage is a percutaneous therapeutic procedure which leads to the drainage of the obstructed bile duct system
  4. 4. Indications • Biliary Stones • Biliary Strictures • Malignancy – pancreas,lymph nodes • Undiagnosed Jaundice
  5. 5. Contraindication • Sepsis • Bleeding Disorders • Contrast Hypersensitivity
  6. 6. Preparation & procedure • US/CT prior to PTBD, which provides useful information regarding the level of obstruction. • The doctors will take a blood sample and send this to the laboratory for testing. • On the day of the examination an intravenous line will be inserted into an arm vein. • One hour prior to the examination intravenous antibiotics will be given through this line.
  7. 7. • It is not allowed to eat for four hours before the examination, but one may drink clear fluids. • Patient will be given the opportunity to ask questions about the procedure before signing a consent form. • The patient will be asked to lie on his/her back on an examination table with the right arm away from the side of your body (above head).
  8. 8. • Monitoring equipment will be attached; this will measure the blood pressure, heart rate and oxygen saturation. • The skin will be cleaned with an antiseptic skin preparation lotion. • Local anaesthetic will be administered into the skin.
  9. 9. • Once the area is numb, the doctor will insert a thin needle through your skin, between the ribs, through the liver, into a bile duct under fluoroscopy guidance . As the needle is withdrawn, a small amount of dye will be injected and x-rays will be taken. • If the PTC results show a problem, such as a blockage in the bile duct, the doctor may replace the thin needle with a small drainage tube (catheter) .A small pouch may be attached to the end of the catheter outside your body to collect bile.
  10. 10. Complications • PAIN • INFECTIONS • BLEEDING
  11. 11. • The blood pressure and pulse will be monitored. • The Haematocrit will be checked. • The catheter site will be checked frequently. • Patient can eat and drink normally, or as instructed by the Doctors. • He/she must be careful not to dislodge the catheter

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