Percutaneous Transhepatic Cholangiogram (PTC), +/- billary stent or drain

Interventional Radiology and Fluoroscopy

Your consultant has requested that you attend for a PTC +/- biliary stent insertion procedure. This leaflet is designed to explain what the examination involves. The examination will be carried out in the x-ray department at The James Cook University Hospital.

What is the test for?

This test is used to alleviate the symptoms of blockages in the bile duct.

Preparation for the test

You will have a small plastic tube (cannula) inserted, then some antibiotics and blood taken before coming to x-ray. The nurse and consultant radiologist (doctor) will explain and gain your consent for the examination before starting. You will be asked to change into a gown if you are not already wearing one.

What the test involves

You will lie on your back on the x-ray table. Some monitoring devices may be attached to your arm. The doctor will then use ultrasound to guide them into the correct position, and then some local anaesthetic will be given under the skin near your liver.

After this has taken effect, you will only feel the doctors hands brushing against your skin as they are working. If pain is not controlled adequately by local anaesthetic, we can provide some via the cannula to help with your pain.

A very fine needle is passed into the biliary ducts using x-ray guidance. An x-ray dye is used to visualise the biliary system on x-ray. The doctor will pass fine wires into the biliary system to allow a stent along this wire. The stent holds the bile duct open where the blockage has narrowed it. This allows bile to flow through it again.

You will likely be an inpatient for this procedure.

After the examination

You will be taken back to the ward/radiology day unit on a trolley/bed and you will need to be on bed rest for at least 4 hours.

You may experience some slight tenderness over the area the doctor has been working on. You may notice some bile, which may be blood stained, gradually filling the bag, if you have one.

The results of the test

The doctor will write in your notes and tell you what they have done after the examination is finished. The consultant in charge of your treatment will discuss any further details with you on the ward or clinic after the examination.

Radiation dose and risk

X-rays use ionising radiation which can cause cell damage that may, after many years or decades, turn cancerous. The risk of this happening is very small compared to the normal lifetime risk of developing cancer which is 1 in 2.

We are also all exposed to background radiation every day. The risk of long-term effects is considered when the healthcare team decide whether someone needs an x-ray examination and radiation doses are kept as low as possible.

For this examination radiation dose levels are typically equivalent to around 1 to 2 years of background radiation. The associated risk is less than 1 in 1000 – Low.

Is there anything I should tell the staff?

For patients who have ovaries and are between the ages of 12 and 55, the x-ray department has a legal responsibility to ensure that this examination is performed within TEN DAYS of the first day of your menstrual period.

Patient experience

South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.

This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.

To ensure we meet your communication needs please inform the Patient Experience Department of any special requirements, for example; braille or large print.

T: 01642 835964
E: [email protected]

The James Cook University Hospital, Marton Road, Middlesbrough, TS4 3BW.
Telephone: 01642 850850

ST3310