What is the primary indication for performing a Percutaneous Transhepatic Cholangiography (PTC)?

The primary indication for performing a Percutaneous Transhepatic Cholangiography (PTC) is biliary obstruction when Endoscopic Retrograde Cholangiopancreatography (ERCP) is unsuccessful. PTC is a procedure used to visualize the bile ducts and is particularly valuable in cases where there is a blockage preventing bile flow.

When ERCP, which is often the first-line procedure for evaluating and treating biliary issues, fails—either due to anatomical complexity, strictures, or other factors—PTC provides a minimally invasive alternative. It allows for direct access to the biliary system through the liver, enabling both diagnosis and intervention, such as stent placement or drainage. By obtaining images directly from the biliary tree, healthcare providers can better assess the nature and location of the obstruction, which is crucial for guiding subsequent treatment decisions.

Other options do not represent the primary indications for PTC. Routine gallbladder function testing typically involves non-invasive imaging techniques rather than PTC, which is more specialized. Visualizing the arterial system relates to vascular imaging techniques, while the diagnosis of liver tumors is managed through different modalities, such as ultrasound, CT, or MRI, rather than PTC, which focuses on the biliary tree.