Transcript
1. T-tube Cholangiogram
2. What is a T-tube Cholangiogram? • A T-tube cholangiogram is an x-ray of the biliary duct system. • These ducts transport bile between your liver, gallbladder, and small intestine are not seen on radiographs without the use of contrast materials. • This contrast is injected via a T-tube, which is normally put in place during surgical procedures ranging from liver transplantation to cholcystectomy.
3. Biliary duct system
4. What can a T-tube Cholangiogram show? • This exam can show blockages within your common bile duct or hepatic ducts. • The most common reason for this exam is to look for remaining stones or stone fragments in the ducts after surgery. • This gives your doctor important information that may help in your diagnosis and treatment. • It can help your doctor decide when to remove your T-tube.
5. What does a T-tube Cholangiogram look like? This is the initial image demonstrating contrast in the T-tube as well as in portions of the common bile duct and the pancreatic duct.
6. What does a T-tube Cholangiogram look like? In this second image of the series, we see that the contrast has spread throughout the right and left hepatic ducts superiorly. We can see the cystic stump clearly with no evidence of leakage. Inferiorly, we can see the common bile duct as it enters the duodenum.
7. What does a T-tube Cholangiogram look like?
8. What does a T-tube Cholangiogram look like?
9. What does a T-tube Cholangiogram look like?
10. What does a T-tube Cholangiogram look like?
11. Are there other methods for obtaining a Cholangiogram? • There are various techniques used to introduce radiographic contrast into the body, including: – Percutaneous transhepatic cholangiography (PTC). – Intraoperative cholangiography. – Endoscopic retrograde cholangiopancreatography (ERCP). – Magnetic resonance cholangiopancreatography (MRCP).
12. Percutaneous transhepatic cholangiography (PTC) • The dye is injected through the skin into the bile ducts within the liver (intrahepatic biliary ducts). • This is done using ultrasound to guide where the needle goes.
13. Intraoperative cholangiography. • The dye is injected directly into the bile duct during a gallbladder operation.
14. Endoscopic retrograde cholangiopancreatography (ERCP). • The dye is injected into the common bile duct and the pancreatic duct through a catheter that’s passed down an endoscope. • The endoscope is a thin, flexible lighted tube that is gently passed down your throat and through your stomach, until it reaches the duodenum.
15. Magnetic resonance cholangiopancreatography (MRCP) • Magnetic resonance cholangiopancreatography is a relatively new technique for viewing the bile ducts, the pancreatic duct and the gallbladder. • Unlike the other techniques mentioned here, no contrast medium has to be administered for MRCP. • It uses magnetic resonance imaging (MRI) to produce detailed pictures.
16. Magnetic resonance cholangiopancreatography (MRCP)
17. • Irrespective of how it is introduced, once the dye is in the bile ducts, it can spread into the whole biliary drainage system. • Then X-rays can be taken to show up any narrowing or blockages in the drainage system. • The resulting radiographic record is called a cholangiogram.