Pediatric Percutaneous Transhepatic Cholangiogram (PTC)

Using ultrasound and live X-ray (fluoroscopy) for guidance, the radiologist will insert a small needle through the skin and liver and into one of the bile ducts. Then the radiologist will inject X-ray dye into the ducts and X-ray images will be obtained.

No. We will use either IV sedation or general anesthesia so that your child isn’t awake.

Your child will not feel pain during the procedure but some patients may feel discomfort around the needle and catheter insertion site for a few days following the procedure.

The procedure will take approximately one hour. Some children may need to arrive may hours before the procedure to have certain lab tests performed, which will be clearly communicated to you.

The procedure is considered low-risk. However, potential complications include:

• Bleeding
• Infection
• Injury to the gallbladder
• Bile leak (biloma)
• Puncture of the lung (very rare)
• Allergic reaction to X-ray dye (contrast reaction)

We encourage good communication between you and your child, including the necessity and overview of the procedure as well as ensuring them that you are close by the whole time. Holding them or their hands until they leave for the procedure is a great way to provide support.

You will be given specific instructions along the way but you may need to arrive a few hours before the scheduled procedure to have some blood tests done. When you arrive at the hospital, a doctor will review the procedure and associated risks, after which you will sign a consent form. When we are ready to get started with the procedure, a nurse will place an intravenous line to deliver sedating medications and you will be allowed to accompany your child in the operating room until they are asleep, after which you will be escorted to a waiting room.

Nurses will monitor your child in the recovery area for a couple hours for successful recovery from any sedating medications, if any, and any immediate complications. The doctor may decide to have your child admitted to the hospital for an overnight stay. As mentioned, there may be some discomfort around the catheter insertion site for some days following the procedure, which is easily relieved by over-the-counter medications. It is important to keep the bandage surrounding the tube clean and dry.

Leave the bandage on for 48 hours. Then you may remove the clear bandage and gauze; do not remove the Steri-Strips^® (white strips). If a drainage catheter was placed, it will be secured with a locking device (StatLock^®), which must not be removed.

Keep the site completely dry for the first 48 hours. After 48 hours, your child may shower or have a sponge bath, but you should continue to keep the area dry. Do not submerge the site in water (bath or pool) until the Steri-Strips have fallen off.

Your child will be able to resume a normal lifestyle and activity as tolerate within a couple days.