Percutaneous Transhepatic Cholangiography in Cholangiocarcinoma: From Diagnosis to Drainage

Introduction: PTC is established technique for the evaluation of intra-hepatic and extra-hepatic bile ducts in patients with cholangiocarcinoma. PTC as a road map is less studied in the era of MRCP. PTC has procedure-related complications with the advantage of the consequent drainage.

Method(s): A prospective observational study, performed between August 2017 and March 2020 on 140 patients (90 males and 50 females) with cholangiocarcinoma. Their ages ranged between 42 and 85 years. All patients were evaluated with MRCP then PTC to assess the biliary anatomy, the diagnosis, the level of obstruction, and the degree of obstruction, and then PTD was done for all the patients either with external, internal–external drainage, or stenting.

Result(s): PTC could assess the degree of obstruction in all the cases and revealed internal biliary fistula in 14 cases. PTC-related minor complications in 28 out of 140 cases (20%). In 38 patients more than one puncture had to be performed during PTC to delineate the whole biliary system.

Conclusion(s): In cholangiocarcinoma, PTC is comparable to MRCP as a diagnostic tool with added value in the assessment of the degree of obstruction, the presence of internal biliary fistula and further drainage.

Publication History

Article published online:
09 February 2023