A Reference Guide For the Care of Your Child’s Biliary Drain

Document created by: Kyle Soltys, MD and the pediatric transplant team at UPMC Children’s Hospital of Pittsburgh.

Percutaneous Transhepatic Cholangiography and Biliary Drainage

The Transplant team has recommended a procedure called a PTC — percutaneous transhepatic cholangiogram. As the PTC is being done, the physician may decide that a biliary drain needs to be placed. This booklet will provide you with information regarding your child’s percutaneous transhepatic cholangiogram (PTC) with biliary drain placement. This booklet also has information about why your child needs the PTC, how to care for the biliary drain, how to change the dressing and participating in normal routine childhood activities after drain placement.

What is a PTC?

Percutaneous Transhepatic Cholangiography (PTC) is a procedure to look at the bile ducts of the liver. The procedure is performed by an interventional radiologist who is skilled in performing procedures, such as PTC’s using special x-rays and ultrasounds.

Why does my child need a PTC?

The liver plays an important role in hundreds of bodily functions. Liver cells make a substance called bile, which leaves the transplanted liver through a bile duct (green circle) that is sew to a piece of intestine (roux limb). Bile contains waste products and also helps with fat absorption. The bile duct may
become narrowed (strictured) preventing bile from leaving the liver.

If bile isn’t draining from the liver, your child may develop:

  • elevated liver tests, especially the gGTP
  • fever from bile infection (cholangitis)
  • right upper abdominal pain
  • itchiness
  • yellowing of the whites of their eyes
  • pale stool
  • leaking bile into the abdomen

The attached resource also includes:

  • How is a bile duct issue diagnosed?
  • The procedure to place a PTC with pictures
  • Caring (dressing change and flushing) for the biliary drain with pictures
  • Bathing with a PTC in place
  • How to explain the PTC to your child
  • Partnering with your child’s school/daycare
  • Helping your child manage peer interactions

This information should not replace medical advice from your doctors or medical team. We encourage our readers to follow their transplant team’s medical advice and reach out to their doctors and medical team for further recommendations.