PTBD (PERCUTANEOUS TRANSHEPATIC BILLIARY DRAINAGE)
*What it is:
It is a procedure where a small, flexible, plastic tube is placed through the skin into the biliary system of liver in order to drain bile (Pitt).
Why it is necessary:
- The liver produces bile which is helpful for digestion of fats. The bile normally flows from small tubes (ducts) to one large duct which then empties into the duodenum (shown in pictorial presentation in green colour).
- If the bile duct becomes blocked, the bile cannot drain normally and accumulate in the liver. Signs of blocked bile ducts include jaundice (yellowing of the skin), dark urine, light stools, itching, nausea and poor appetite.
- This is a potentially serious condition that needs to be treated. So relieve of obstruction done by inserting a fine plastic drainage tube (catheter) through the skin (percutaneous) into the obstructed bile duct, past the obstruction and into the duodenum (called internalization), as shown in lower picture.
Preparation for procedure:
- Few basic blood investigations like CBC, PT/INR, viral markers.
- Bring all the records including imaging record.
- Signing consent form.
Duration of procedure:
- We are fast and competent to provide you comfortable environment and ease your anxiety. Approx. time for procedure is 30 min to 1 hour.
Precaution to be taken by patient:
- Care for catheter to prevent its accidental removal and proper dressing, to minimize complication like haemorrhage and infections.
What are risk:
- Fever and bleeding (1-2 %).
Sometimes the biliary drainage procedure may be extended with the placement of a plastic or permanent metal stent across the site of the bile duct blockage.
Advantage of Stents: To keep the narrowed duct open without the need for a catheter. Sometimes stenting may be preceded or followed by biliary dilatation, which involves dilating a segment of bile duct with a balloon to open up the stricture.
