This procedure is similar to the ERCP and takes X-ray images of the bile duct. PTC cannot obtain pictures of the pancreatic duct. Since most pancreatic cancers block the bile duct as well as the pancreatic duct, it can be a useful test for diagnosing pancreatic cancer.

Like the ERCP, the PTC does not directly "see" the cancer. Rather, the X-ray images demonstrate the indirect effects of the cancer. Blockages and dilatations of the bile ducts can be easily seen once the dye is injected and suggest that a cancer may be present. By examining the pattern of these changes, it is possible to predict (with a high degree of certainty if an abnormality is cancer). PTC can often distinguish cancer from other bile duct strictures caused by inflammation brought on by stones or other conditions. Stones in the bile duct can cause symptoms similar to those of pancreatic cancer. If a stone is present it can be removed.

PTC is used to take pictures of the bile ducts that drain the liver. Unlike the ERCP that uses an endoscope to obtain clear images, the PTC uses the insertion of a small needle into the liver to reach the bile ducts. Once in the bile duct, a radio-opaque dye is injected into the biliary system and pictures are taken. The pictures can be examined and evaluated on a flouroscopy screen by the attending radiologist.

If necessary, a sample of bile can be obtained during PTC or during another procedure such as ERCP. Stents can also be inserted over a blockage in the bile ducts. Some blockages that develop in the pancreas are better stented with ERCP and some with PTC depending on ???

Infection and bleeding are the main complication of PTC. The risk of infection is greatly reduced with the routine use of pre-procedure intravenous antibiotics. Serious complications occur in about 1 in 250 procedures where PTC is performed for obtaining pictures without additional therapy. Inserting stents to treat patients with PC who have bile duct blockage can result in bile leakage in 1-3 % of patients. This requires hospitalization, antibiotics and in some cases surgical correction. The risk of bleeding is also increased by stent insertion. As with several other procedures, there may be a small risk of an allergic reaction to the iodine in the dye.