Percutaneous transhepatic cholangiography (PTC) in biliary atresia with special reference to the structure of the intrahepatic bile ducts.

Percutaneous transhepatic cholangiography (PTC) was carried out in 30 cases of biliary atresia, 19 prior to surgery, and 11 following hepatic portoenterostomy. The intrahepatic biliary system was demonstrated in 47% of the patients prior to surgery and in all cases following surgery. Two distinct patterns of intrahepatic bile ducts were noted. The first shows changes similar to those noted by intrahepatic cholangiography in patients with choledochal cyst, as in type A. The second pattern shows collections of numerous narrow proliferated bile ducts that constitute the ducts within and outside the liver as in type B. In patients with recurrent ascending cholangitis or symptoms suggestive of stenosis of the hepatointestinal anastomosis following Kasai-type operations for biliary atresia, PTC is useful in determining the structure of the hepatobiliary ductal system prior to reexploration procedures.