Percutaneous Transhepatic Cholangioscopy

The role of the interventional radiologist continues to expand in the treatment of biliary disease. Percutaneous transhepatic cholangioscopy (PTCS) provides direct visualization of the biliary system for diagnostic and therapeutic interventions, especially in cases where anatomical considerations pr...

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Bibliographic Details
Published in:Techniques in vascular and interventional radiology 2015-12, Vol.18 (4), p.201-209
Main Authors: Ahmed, Sameer, MD, Schlachter, Todd R., MD, Hong, Kelvin, MD
Format: Article
Language:English
Subjects:
biliary intervention
Biliary Tract Diseases - diagnosis
Biliary Tract Diseases - surgery
Biopsy
Cholangiopancreatography, Endoscopic Retrograde - adverse effects
Cholangiopancreatography, Endoscopic Retrograde - instrumentation
cholangioscopy
Endoscopes
Equipment Design
ERCP
Hematology, Oncology and Palliative Medicine
Humans
Predictive Value of Tests
Radiography, Interventional - adverse effects
Radiography, Interventional - instrumentation
Radiography, Interventional - methods
Radiology
transhepatic
Treatment Outcome
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Summary:The role of the interventional radiologist continues to expand in the treatment of biliary disease. Percutaneous transhepatic cholangioscopy (PTCS) provides direct visualization of the biliary system for diagnostic and therapeutic interventions, especially in cases where anatomical considerations prohibit a peroral approach. Visual inspection and endoscopically guided biopsy allow differentiation between benign and malignant lesions, as well as accurate assessment of the tumor extent for surgical planning. Studies have demonstrated greater than 95% accuracy with PTCS in diagnosing biliary malignancies. Cholangioscopy is also used to treat obstructive stones in the biliary system, which may require laser lithotripsy. PTCS-guided removal of biliary stones is highly successful, with complete stone removal from the bile ducts occurring in approximately 90% of cases. Overall, PTCS is a safe and effective procedure, with severe complications occurring in less than 8% of patients. The purpose of this review is to familiarize its reader with common indications for PTCS, techniques for procedural success, expected outcomes, and management of potential complications.
ISSN:1089-2516
1557-9808
DOI:10.1053/j.tvir.2015.07.003