Percutaneous transhepatic biliary drainage (PTD)

Percutaneous transhepatic biliary drainage is performed by X-ray examination of the biliary tract. It is helpful to observe residual stones or other diseases in the bile duct and to understand the patency of the bile duct and duodenum. PTD is an interventional radiotherapy technology developed on the basis of PTC. If the biliary system is combined with ultrasound and conventional X-ray examination, it can diagnose most biliary tract diseases with high accuracy, less false positives, and no trauma to patients. Basic Information Specialist classification: Digestive examination classification: X-ray Applicable gender: whether men and women apply fasting: fasting Tips: Remove all metal items before inspection. Normal value 1. Indwelling t-shaped drainage tube after biliary surgery. 2. There is no serious biliary infection symptoms, and the bile that is drained out is clear and not turbid. Clinical significance PTD is an interventional radiotherapy technology developed on the basis of PTC. If the biliary system is combined with ultrasound and conventional X-ray examination, it can diagnose most biliary tract diseases with high accuracy, less false positives, and no trauma to patients. People who need to be tested: severe obstructive jaundice. Precautions Before inspection: Remove all metal objects. At the time of examination: angiography should be performed under fluoroscopy. Inspection process 1. Position and operation method can be referred to the ultrasound guided puncture cytology section. 2. Puncture point selection: Select the bile duct that is most prominently dilated and close to the abdominal wall, such as the left outer branch, or the left branch or the right front lower branch. 3. Intrahepatic bile duct expansion of more than 0.6cm, puncture is easy to succeed, with 18G guide needle, 22G puncture needle. 4. When the puncture is successful, the bile is discharged from the needle core, and the bile is discharged or drawn, and then the catheter is drained or X-ray contrast agent is injected. 5. Operation of indwelling catheter: There is a plastic sleeve at the puncture needle. After successful puncture, push the plastic sleeve into the bile duct as much as possible, pay attention to keep the drainage smooth, then pull out the puncture needle, and connect the end of the plastic sleeve with the drainage tube, and Fixed to the skin. 6. Apply antibiotics to prevent infection before, during and after surgery. Not suitable for the crowd Not suitable for people: it is not suitable for obvious infection. Coagulopathy, bleeding tendency, liver and kidney dysfunction, massive ascites, allergic to iodine contrast agents are classified as contraindications. Adverse reactions and risks May aggravate the infection.