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You don't know about bile duct exploration: What is the scientific principle behind percutaneous hepatobiliary angiography?
In today's medicine, percutaneous hepatobiliary contrast (PTHC), a radiological technique originated in 1937, has become an important tool for understanding and treating the biliary system. The principle of this technology is to inject contrast agent into the bile ducts of the liver and then take X-rays to visualize the structure of the bile ducts. If endoscopic retrograde cholangiopancreatography (ERCP) fails, PTHC can provide an alternative solution to help doctors clearly visualize the structure of the biliary system and any potential problems.
The use of percutaneous hepatobiliary imaging is not limited to diagnosis, but can also be used during treatment to drain or place stents in the bile duct or even remove stones.
PTHC has a wide range of applications, from relieving obstructive jaundice, placing stents to dilate bile duct strictures, to extracting stones. Some of the complex techniques, such as the "rendezvous technique", allow the guidewire to pass from the common bile duct into the duodenum, achieving a more Flexible surgical options. Generally, patients are required to fast for four hours before the procedure, and doctors may choose to give antibiotics to prevent infection. At the same time, monitoring of vital signs and preparation for anesthesia and analgesia are also critical.
The success rate of percutaneous hepatobiliary angiography is closely related to the degree of bile duct dilation. The greater the dilation, the easier it is to insert the guide needle.
But not everyone is suitable for this surgery. For patients with obvious bleeding tendency, such as platelet count lower than 100 x 10^9/L, or coagulation time two seconds longer than normal, doctors will postpone or cancel the operation depending on the situation. In addition, patients with biliary tract infection also need to be carefully considered, and drainage is usually performed only when the infection is controlled.
Although PTHC is a relatively safe procedure, there are still some potential complications. Compared with endoscopic biliary drainage, PTHC may increase the risk of metastasis, catheter deviation, and bleeding, but the risk of cholangitis and pancreatitis is relatively low. This may be related to the lower success rate of the latter in draining infected bile.
In addition, percutaneous hepatobiliary drainage (PTBD) is often used to treat biliary obstruction due to hepatocellular carcinoma, especially when endoscopic drainage fails.
In some cases where it is necessary to remove preserved gallstones, percutaneous hepatobiliary techniques have become an option. For example, PTBD can provide effective assistance for cases where endoscopic access is difficult due to gastrointestinal remodeling. During this procedure, your doctor will use high or low osmotic contrast media and will perform the necessary antimicrobial prophylaxis and anesthesia.
Even when performing T-tube cholangiography after surgery, attention should be paid to different types of contrast agents and their effects on patients. This technique can be performed ten days after surgery to ensure that there are no leaks or stones remaining in the bile duct. Every step the doctor takes must be precise and cautious to avoid affecting the patient's health.
Percutaneous hepatobiliary technology not only provides doctors with tools to deal with complex biliary problems, but also improves patient outcomes and prognosis.
With the advancement of medical technology, percutaneous hepatobiliary imaging provides new ideas for the diagnosis and treatment of bile duct-related diseases. However, while pursuing technological advancement, we should also pay attention to its potential risks and the overall health of patients. How will the promotion of this technology change future medical practice?
