Percutaneous Transhepatic Cholangiography (PTC)
Percutaneous transhepatic cholangiography (PTC) is carried out by various methods according to puncture sites. With the right lateral approach [4, 6, 7], the puncture site is selected in the intercostal space on the right lateral chest wall; the anterior approach  is situated below the right costal arch. These two methods are frequently utilized. Another method is via the retroperitoneum. The right lateral approach is advantageous to obtain cholangiograms  because the liver can be punctured adequately, leakage of bile juice and hemorrage from the liver are prevented due to the long distance from the punctured bile duct, and the risk of puncturing the gallbladder remains minor. Although it is also valuable for the technique of internal bile drainage, the anterior approach is more useful not only to drain the internal bile but to excrete the bile juice to the duodenum in inoperable cases of bile duct carcinoma by introduction of the catheter through the tumor . The inserted catheter in the anterior approach is holded more stably than in the lateral method because the catheter is less moved by respiration.
KeywordsCatheter Respiration Gall Noma Cholelithiasis
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Percutaneous Transhepatic Cholangiography
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