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adv pos biliary

IV biliary flouro set 3 - ERCP and PTC

QuestionAnswer
PTC percutaneous transhepatic choangiography – pre-op study of the biliary tract
What is the purpose of a PTC? when cause of dilation of biliary ducts shown on CT or US is unclear in jaundice pt, or placement of a drainage catheter to treat obstructive jaundice
PTC procedure – pt. position pt. supine, R side is prepped for surgery
PTC procedure – anesthetic and contrast administration local anesthetic administered via chiba needle into R lat. Intercostal space and advanced toward the hilum. Stylet is removed and a contrast filled syringe is attached.
PTC risks liver hemorrhage, bile leakage, infection.
ERCP endoscopic retrograde cholangiopancreatography – procedure used to diagnose biliary and pancreatic pathologic conditions
ERCP – purpose/use biliary ducts are not dilated, no obstruction at ampulla of vater, abnormal biliary or pancreatic findings
ERCP is performed following what exams? OCG, ultrasound and IVC. Ultrasound for pseudocysts
ERCP procedure endoscope is passed into the duodenum under flouro, anesthetic sprayed into throat, conscious sedation. A cannula is passed into the ampulla
ARCP procedure – contrast injected into the common bile duct, spots taken and flouro to be performed within 5 minutes due to rapid drainage.
Why would dense contrast be used in an ERCP? to opacify small ducts , may obscure small stones.
Why would dilute contrast be used in an ERCP? to show small stones
Why would we do obliques on an ERCP? to prevent overlapping of the common bile duct and pancreatic duct.
Created by: annaluz87
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