Radiology Diagnostic

A percutaneous cholangiogram is a type of X-ray examination of the bile ducts inside and outside the liver performed after a contrast dye is injected. Following administration of a local anesthetic, a long, thin, flexible needle is inserted through the skin into the liver. With guidance from a fluoroscope (an X-ray machine that projects images onto a TV screen), the bile duct is located and the contrast dye injected. The contrast dye then flows through the ducts and can be seen on the fluoroscopic monitor.

There will be a sting as the anesthetic is given and some discomfort as the needle is advanced into the liver. You may be given medication for sedation and/or pain control. Generally, an X-ray causes little or no discomfort.

Bile is a by-product of protein metabolism that is created in the liver and excreted into the intestines through the bile ducts. If bile cannot be removed from the body, it collects in the blood and is seen as a yellow discoloration of the skin and eyes (jaundice). The pancreas creates digestive fluids that also drain through the bile ducts into the intestines. Therefore, obstruction of bile ducts can prevent the drainage of the fluids and may cause pancreatitis (inflammation of the pancreas). A percutaneous cholangiogram may distinguish between obstructive and non-obstructive causes of jaundice and pancreatitis. If there is an obstruction, it can then be located and described.

The results may show ducts that are dilated, which may indicate there is an obstruction. The obstruction may be caused by infection, scarring, stones or cancer in the bile ducts, liver, pancreas or the region of the gallbladder.

There is a slight chance of an allergic reaction to the contrast dye (iodine). There is also a slight chance of excessive blood loss, blood poisoning (sepsis) and inflammation of the bile ducts.