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    Percutaneous Transhepatic Cholangiogram (PTHC) with Biliary Drainage (PTBD)

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    What is a PTHC With Biliary Drainage?

    A Percutaneous Transhepatic Cholangiogram (PTHC) is a procedure performed by an Interventional Radiologist (IR) in the Department of Radiology. During this procedure, the IR injects x-ray contrast into the bile ducts. The IR will study the condition of the bile ducts in the liver by using specialized x-ray equipment.

    Often, a PTHC is done at the same time as a Percutaneous Transhepatic Biliary Drainage (PTBD) procedure. A PTBD is a specialized procedure done to relieve blockages in the bile ducts without having to perform surgery. This procedure will not cure the disease causing the blockage in your bile ducts. During a PTBD procedure, a catheter (thin tube) is placed within the bile ducts to relieve pressure caused by narrowing or blockage, such as gallstones, strictures, or tumors.

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    What Do I Need to Know Before the Procedure?

    • Pre-registration is a two-step process that you must complete before having a surgery, test, or procedure at California Pacific Medical Center.
      1. Health History. Please call (415) 600-2500 within 1- 2 weeks before your procedure to speak with a Pre-admission Testing nurse who will take your health history, answer your questions, and explain what testing is necessary before your surgery, test, or procedure.

        Based on your health status, the nurse may send you to complete any required testing before you come to the hospital. The nurse will tell you where you can go for your test(s).
      2. Pre-Registration. The nurse will connect you to the Patient Access Center to complete the pre-registration process. Please be sure to have your insurance card information ready when you begin.
    • Do not eat or drink anything within 6 hours of your procedure, unless otherwise directed by your doctor. However, you may continue to take your routine medications, such as heart and blood pressure medications, with only a sip of water.

    • Come to the Ambulatory Care Unit (ACU) 2 hours before your scheduled procedure. The ACU is located at 2351 Clay Street on the 6th Floor. Note: Non-English speaking patients are encouraged to come with an English speaking family member or translator.

    • Parking is available at 2405 Clay Street at Webster. There is no validation for parking.

    • You may not drive or take a cab home alone after this procedure.

    • Bring a list of your medications and insurance information.

    • An intravenous line (IV) will be placed in your arm. The IV is needed to give you medications such as antibiotics to help prevent infection. You will also be given medications to help you relax during the procedure to ensure that you are comfortable. You may have blood tests taken if needed.

    • Signing the consent form. In Radiology, the IR will explain the procedure to you and ask you to sign a consent form stating that you understand the procedure you are having. This is a good time for you to ask questions and to share any concerns you may have.

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    What Can I Expect During the Procedure?

    During the test, a member of the staff will place small devices on your finger and chest to monitor your blood pressure, pulse, and oxygen level. You will be given medication in your IV to help you relax. Next, the skin over your abdomen is cleaned with an iodine solution and covered with a sterile drape. The IR will inject local anesthesia (numbing medication) into the skin on the right side of your abdomen. You may feel some discomfort during the procedure. Please be sure to tell your doctor if you are feeling any discomfort.

    The IR uses ultrasound or X-ray pictures to guide a fine needle through the skin, into the liver, and directly into the bile ducts. X-ray contrast is injected through the needle which allows the IR to see the bile ducts within the liver. Then, the IR will take X-ray pictures of the bile ducts under examination, including pictures that record obstructions and narrowing of the ducts. Next, the IR inserts a catheter into the bile duct to relieve pressure or blockage. This catheter may remain in place until after you go home. Your nurse will give you instructions on how to care for the tube and/or drainage bag at home.

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    What Can I Expect After the Procedure?

    • Depending on the results of your examination, the IR may or may not remove the catheter. If the catheter is left in place, it will be taped securely to the skin.

    • After the test, you will return to the ACU on a gurney. In the ACU, your nurse will monitor your pulse, blood pressure and check the catheter entry site on your abdomen for any bleeding or bruising.

    • You may eat as soon as you feel up to it.

    • Before you go home, you will receive specific instructions on how to care for your catheter from your doctor and the nursing staff. These instructions will also include the important symptoms to watch out for such as fever, increased pain, or bloody drainage from the catheter.

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    More Ways to Learn

    Go to the Society of Interventional RadiologyOpens new window Web site.

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    Frequently Asked Questions

    Question: During a PTHC, what does the doctor do with the condition of the bile ducts in the liver?
    Answer: During a PTHC, the doctor studies the condition of the bile ducts in the liver.

    Question: Do patients feel pain with this procedure?
    Answer: It is normal to feel some discomfort during the test. You will be given medication to keep you comfortable during the procedure. Please be sure to let your doctor or nurse know if you are feeling any discomfort.

    Question: Can I drive home after the procedure?
    Answer: No, you may not drive home alone after this procedure.

    Produced by the staff and physicians at California Pacific Medical Center in association with the Center for Patient and Community Education. Last updated: 03/15.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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