Percutaneous transhepatic cholangiography (PTC): Minimally invasive radiologic technique used to visualize biliary tract anatomy
Needle introduced through skin into liver to access biliary tract and inject contrast medium
Usually combined with percutaneous intervention
Percutaneous biliary drainage (PBD): Placement of drainage catheter into biliary tract
External drainage: Percutaneous biliary drain with catheter tip in biliary system
Internal/external drainage: Percutaneous biliary drain with catheter tip in bowel
Biliary metal stent: Covered or uncovered self-expanding metal stent (SEMS) placed in biliary tree for drainage
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
Things to Avoid
OUTCOMES
Complications
Expected Outcomes
Selected References
Rudnick MR et al: Contrast-associated and contrast-induced acute kidney injury: clinical features, diagnosis, and management. Updated July 2020. Accessed April 12, 2022. https://www.uptodate.com/contents/contrast-associated-and-contrast-induced-acute-kidney-injury-clinical-features-diagnosis-and-management
Devane AM et al: Society of Interventional Radiology quality improvement standards for percutaneous cholecystostomy and percutaneous transhepatic biliary interventions. J Vasc Interv Radiol. 31(11):1849-56, 2020
Chehab MA et al: Adult and pediatric antibiotic prophylaxis during vascular and IR procedures: a Society of Interventional Radiology practice parameter update endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Association for Interventional Radiology. J Vasc Interv Radiol. 29(11):1483-501.e2, 2018
Kapoor BS et al: Management of biliary strictures: state-of-the-art review. Radiology. 289(3):590-603, 2018
Tringali A et al: Covered vs. uncovered self-expandable metal stents for malignant distal biliary strictures: a systematic review and meta-analysis. Endoscopy. 50(6):631-41, 2018
Venkatanarasimha N et al: Diagnosis and management of complications from percutaneous biliary tract interventions. Radiographics. 37(2):665-80, 2017
Ahmed O et al: Biliary interventions: tools and techniques of the trade, access, cholangiography, biopsy, cholangioscopy, cholangioplasty, stenting, stone extraction, and brachytherapy. Semin Intervent Radiol. 33(4):283-90, 2016
Inamdar S et al: Comparison of adverse events for endoscopic vs percutaneous biliary drainage in the treatment of malignant biliary tract obstruction in an inpatient national cohort. JAMA Oncol. 2(1):112-7, 2016
Thomas S et al: Noninvasive imaging of the biliary system relevant to percutaneous interventions. Semin Intervent Radiol. 33(4):277-82, 2016
Wible BC et al: Ethylene-vinyl alcohol copolymer endobiliary obliteration of hepatic segments in a patient with isolated bile leaks. J Vasc Interv Radiol. 25(11):1821-5, 2014
Kim JH et al: Temporary placement of retrievable fully covered metallic stents versus percutaneous balloon dilation in the treatment of benign biliary strictures. J Vasc Interv Radiol. 22(6):893-9, 2011
Thornton RH et al: Catheter-free survival after primary percutaneous stenting of malignant bile duct obstruction. AJR Am J Roentgenol. 197(3):W514-8, 2011
Kullman E et al: Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study. Gastrointest Endosc. 72(5):915-23, 2010
Moon E et al: Prophylactic antibiotic guidelines in modern interventional radiology practice. Semin Intervent Radiol. 27(4):327-37, 2010
Saad WE et al: Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol. 21(6):789-95, 2010
Telford JJ et al: A randomized trial comparing uncovered and partially covered self-expandable metal stents in the palliation of distal malignant biliary obstruction. Gastrointest Endosc. 72(5):907-14, 2010
Brown KT et al: Management of malignant biliary obstruction. Tech Vasc Interv Radiol. 11(1):43-50, 2008
Covey AM et al: Percutaneous transhepatic biliary drainage. Tech Vasc Interv Radiol. 11(1):14-20, 2008
Fidelman N et al: Hepatic arterial injuries after percutaneous biliary interventions in the era of laparoscopic surgery and liver transplantation: experience with 930 patients. Radiology. 247(3):880-6, 2008
Saad WE et al: Management of bleeding after percutaneous transhepatic cholangiography or transhepatic biliary drain placement. Tech Vasc Interv Radiol. 11(1):60-71, 2008
Saad WE: Transhepatic techniques for accessing the biliary tract. Tech Vasc Interv Radiol. 11(1):21-42, 2008
Calvo MM et al: The rendezvous technique for the treatment of choledocholithiasis. Gastrointest Endosc. 54(4):511-3, 2001
Gazelle GS et al: Cholangiographic segmental anatomy of the liver. Radiographics. 14(5):1005-13, 1994
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Preprocedure
Procedure
Outcomes
TERMINOLOGY
Definitions
Percutaneous transhepatic cholangiography (PTC): Minimally invasive radiologic technique used to visualize biliary tract anatomy
Needle introduced through skin into liver to access biliary tract and inject contrast medium
Usually combined with percutaneous intervention
Percutaneous biliary drainage (PBD): Placement of drainage catheter into biliary tract
External drainage: Percutaneous biliary drain with catheter tip in biliary system
Internal/external drainage: Percutaneous biliary drain with catheter tip in bowel
Biliary metal stent: Covered or uncovered self-expanding metal stent (SEMS) placed in biliary tree for drainage
PREPROCEDURE
Indications
Contraindications
Preprocedure Imaging
Getting Started
PROCEDURE
Patient Position/Location
Procedure Steps
Findings and Reporting
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
Things to Avoid
OUTCOMES
Complications
Expected Outcomes
Selected References
Rudnick MR et al: Contrast-associated and contrast-induced acute kidney injury: clinical features, diagnosis, and management. Updated July 2020. Accessed April 12, 2022. https://www.uptodate.com/contents/contrast-associated-and-contrast-induced-acute-kidney-injury-clinical-features-diagnosis-and-management
Devane AM et al: Society of Interventional Radiology quality improvement standards for percutaneous cholecystostomy and percutaneous transhepatic biliary interventions. J Vasc Interv Radiol. 31(11):1849-56, 2020
Chehab MA et al: Adult and pediatric antibiotic prophylaxis during vascular and IR procedures: a Society of Interventional Radiology practice parameter update endorsed by the Cardiovascular and Interventional Radiological Society of Europe and the Canadian Association for Interventional Radiology. J Vasc Interv Radiol. 29(11):1483-501.e2, 2018
Kapoor BS et al: Management of biliary strictures: state-of-the-art review. Radiology. 289(3):590-603, 2018
Tringali A et al: Covered vs. uncovered self-expandable metal stents for malignant distal biliary strictures: a systematic review and meta-analysis. Endoscopy. 50(6):631-41, 2018
Venkatanarasimha N et al: Diagnosis and management of complications from percutaneous biliary tract interventions. Radiographics. 37(2):665-80, 2017
Ahmed O et al: Biliary interventions: tools and techniques of the trade, access, cholangiography, biopsy, cholangioscopy, cholangioplasty, stenting, stone extraction, and brachytherapy. Semin Intervent Radiol. 33(4):283-90, 2016
Inamdar S et al: Comparison of adverse events for endoscopic vs percutaneous biliary drainage in the treatment of malignant biliary tract obstruction in an inpatient national cohort. JAMA Oncol. 2(1):112-7, 2016
Thomas S et al: Noninvasive imaging of the biliary system relevant to percutaneous interventions. Semin Intervent Radiol. 33(4):277-82, 2016
Wible BC et al: Ethylene-vinyl alcohol copolymer endobiliary obliteration of hepatic segments in a patient with isolated bile leaks. J Vasc Interv Radiol. 25(11):1821-5, 2014
Kim JH et al: Temporary placement of retrievable fully covered metallic stents versus percutaneous balloon dilation in the treatment of benign biliary strictures. J Vasc Interv Radiol. 22(6):893-9, 2011
Thornton RH et al: Catheter-free survival after primary percutaneous stenting of malignant bile duct obstruction. AJR Am J Roentgenol. 197(3):W514-8, 2011
Kullman E et al: Covered versus uncovered self-expandable nitinol stents in the palliative treatment of malignant distal biliary obstruction: results from a randomized, multicenter study. Gastrointest Endosc. 72(5):915-23, 2010
Moon E et al: Prophylactic antibiotic guidelines in modern interventional radiology practice. Semin Intervent Radiol. 27(4):327-37, 2010
Saad WE et al: Quality improvement guidelines for percutaneous transhepatic cholangiography, biliary drainage, and percutaneous cholecystostomy. J Vasc Interv Radiol. 21(6):789-95, 2010
Telford JJ et al: A randomized trial comparing uncovered and partially covered self-expandable metal stents in the palliation of distal malignant biliary obstruction. Gastrointest Endosc. 72(5):907-14, 2010
Brown KT et al: Management of malignant biliary obstruction. Tech Vasc Interv Radiol. 11(1):43-50, 2008
Covey AM et al: Percutaneous transhepatic biliary drainage. Tech Vasc Interv Radiol. 11(1):14-20, 2008
Fidelman N et al: Hepatic arterial injuries after percutaneous biliary interventions in the era of laparoscopic surgery and liver transplantation: experience with 930 patients. Radiology. 247(3):880-6, 2008
Saad WE et al: Management of bleeding after percutaneous transhepatic cholangiography or transhepatic biliary drain placement. Tech Vasc Interv Radiol. 11(1):60-71, 2008