Percutaneous Transhepatic Biliary Drainage Surgical procedure Definition indications Uses

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Percutaneous Transhepatic Biliary Drainage (PTBD) • Definition: • PTBD is a minimally invasive procedure to drain bile from the liver through the skin. • Indications: • 1. Obstructive jaundice • 2. Biliary atresia • 3. Cholangiocarcinoma • 4. Pancreatic cancer • 5. Liver metastases • 6. Bile duct injuries • 7. Intrahepatic bile duct obstruction • Procedure: • 1. Imaging guidance (ultrasound, CT) • 2. Local anesthesia • 3. Percutaneous puncture of liver • 4. Insertion of drainage catheter • 5. Bile drainage and collection • Techniques: • 1. Seldinger technique (needle, wire, catheter) • 2. Trocar technique (direct catheter insertion) • 3. Endoscopic guidance (PTBD with ERCP) • Benefits: • 1. Relieves obstructive jaundice • 2. Reduces bilirubin levels • 3. Improves liver function • 4. Enhances nutritional absorption • 5. Palliates symptoms • Risks and Complications: • 1. Bleeding • 2. Infection • 3. Liver damage • 4. Bile leakage • 5. Pneumothorax • 6. Hemobilia (bleeding into bile ducts) • 7. Catheter malfunction • Pre-Procedure Preparation: • 1. Imaging studies (CT, MRI, ultrasound) • 2. Blood tests (coagulation, liver function) • 3. Antibiotics • 4. Patient education • Post-Procedure Care: • 1. Monitoring for complications • 2. Pain management • 3. Antibiotics • 4. Fluid and electrolyte replacement • 5. Follow-up appointments • #Hepatic

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