1. PTC & PTBD
Dr Nikrish S Hegde

5. 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).

6. PTBD
• A Percutaneous Transhepatic Biliary Drainage
is a percutaneous therapeutic procedure
which leads to the drainage of the obstructed
bile duct system

7. Indications
• Biliary Stones
• Biliary Strictures
• Malignancy – pancreas,lymph nodes
• Undiagnosed Jaundice

8. Contraindication
• Sepsis
• Bleeding Disorders
• Contrast Hypersensitivity

9. 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.

10. • 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).

11. • 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.

12. • 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withdrawn, a small amount of dye will be injected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.

14. Complications
• PAIN
• INFECTIONS
• BLEEDING

15. • 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