Percutaneous transhepatic cholangiography: Difference between revisions

Revision as of 22:52, 10 January 2022

Revision as of 23:13, 10 January 2022

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==Technique==

It is predominantly now performed as a therapeutic technique. There are less invasive means of imaging the biliary tree including transabdominal ultrasound, [[magnetic resonance cholangiopancreatography]], [[computed tomography]] and [[endoscopic ultrasound]]. If the biliary system is obstructed, percutaneous transhepatic cholangiography may be used to perform [[biliary drainage]] until a more permanent solution for the obstruction is performed (e.g. surgery). Additionally, self expanding metal stents can be placed across malignant biliary strictures to allow palliative drainage. Percutaneous placement of metal stents can be utilised when therapeutic endoscopic retrograde cholangiopancreatography has been unsuccessful, anatomy is altered precluding endoscopic access to the duodenum, or where there has been separation of the segmental biliary drainage of the liver, allowing more selective placement of metal stents.{{cn|date=January 2022}}

Cholangiography during a [[Bile duct#Drainage|biliary drainage]] intervention is called ''perioperative'' or ''primary'' choloangiography, and when performed later in the same drain it is called ''secondary'' cholangiography.<ref name="SchuberthSjogren2010">{{cite journal|last1=Schuberth|first1=O. O.|last2=Sjogren|first2=S. E.|title=On Cholangiography|journal=Acta Radiologica|volume=22|issue=5-6|year=2010|pages=780–795|issn=0001-6926|doi=10.3109/00016924109136457}}</ref>

==Indications==

Cholestatic jaundice, to exclude extra hepatic bile duct obstruction, prior to biliary drainage procedure.{{cn|date=January 2022}}

If endoscopic retrograde cholangiopancreatography has failed and/or there is an obstruction in the proximal biliary tree.{{cn|date=January 2022}}

==Contraindications==