Doctor insights on:
Is The Percutaneous Transhepatic Cholangiography A Risky Thing To Do
No, but...: There are less invasive ways to image the biliary tree, like ultrasound, ERCP (by a gastroenterologist) and mrcp (mri). If there is some blockage, drainage can usually be achieved by a gastroenterologist, with percutaneous drainage reserved for cases that cannot be treated by a gastroenterologist. While percutaneous biliary imaging and interventions do not have high risk, less risky options exist. ...Read more
In surgery, percutaneous pertains to any medical procedure where access to inner organs or other tissue is done via needle-puncture of the skin, rather than by using an "open" approach where inner organs or tissue are exposed (typically with the use of a scalpel). The percutaneous approach is commonly used in vascular procedures. This involves a needle catheter getting access ...Read more
Whats percutaneous cholecystectomy? Whats transhepatic biliary catheter? Whats biliary stent? Are they effective alternatives to a cholecystectomy?
Possibly: Percutaneous cholecystostomy is a tube placed through the skin into the gb for drainage. Thbc is a tube passed through the skin, the liver, and into the bile duct system, a form of biliary stent. Some stents can be passed into the lower duct using an endoscope through the stomach. Any may be necessary in some cases, but cholecystectomy would be the gold standard in most cases. Good luck. ...Read more
Bile Duct X-ray: A cholangiogram is an x-ray of the bile duct utilizing an injection of dye in order to look for abnormalities such as bile duct stones, strictures, tumors, etc. The injection may be performed by a surgeon at the time of gallbladder surgery, by a gastroenterologist at the time of an ercp, or by a radiologist, by using ct- or ultrasound guidance, to inject through the liver. ...Read more
Before I have cholecystectomy, do I have to ask my surgeon to do intra-operative cholangiography, or is this standard procedure during surgery?
Yes, ask: There is still substantial debate whether intraoperative cholangiography (ioc) should be routine or selective. There are clear indications for ioc, such as having elevated bilirubin and common bile duct stone on ultrasound - while having a history of gallstone pancreatitis is a relative indication. If a stone is seen on ioc, some surgeons are facile in removing them, otherwise endoscopic removal. ...Read moreSee 1 more doctor answer
If my surgeon sees a stone in the pancreatic duct or common bile duct during intra-operative cholangiography, can he remove the stone during surgery?
Retained Stones: In the era prior to ercps, stones that left the gallbladder and entered into the common bile duct (cbd) had to be surgically removed by opening the cbd. At the end of the cbd exploration, a t-shaped tube is placed into the bile duct to prevent bile leakage from the duct and to allow a portal of entry into the cbd to retrieve any cbd stones left behind. The t-tube 'gram searches for these stones. ...Read more
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