MEDRADSC 3C03 Lecture Notes - Lecture 20: Cystic Duct, Biliary Tract, Cholecystostomy

• School: McMaster University
• Department: Medical Radiation Sciences
• Course: MEDRADSC 3C03
• Professor: Meaghan Jefferson

Document Summary

Often done in patients with minimally sized ih ducts. Pcc is performed under sedation, provides assessment of intrahepatic & extrahepatic biliary anatomy (within the liver & external to the liver) If there is an obstruction, it must be below junction of cystic duct & cbd. So we can see the area of interest. Direct puncture into gallbladder (22g) - if there is a chance of infection, a larger g needle will be used (drainage is most likely going to be needed) Us guidance is used to assess the puncture site (first step) Once in the gallbladder, we switch to contrast & fluoro to confirm site & assess anatomy. Pcc is often avoided when us shows a small collapsed gallbladder bc it often predicts an unsatisfactory cholangiography. Could be in spasm, or scarred from infection. Imaging of the gallbladder in this case will not be useful - go for another route of imaging.