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Percutaneous transhepatic cholangiography is used to delineate the anatomy of the biliary tract.
Radio-opaque contrast medium is injected directly into a bile radical permitting radiographic assessment of any mechanical obstructions to flow.
PTC may be used instead of ERCP, according to the local expertise. In some circumstances PTC may be used to investigate the biliary system proximal to an obstruction and an ERCP may be used to examine the distal anatomy.
A stone in the biliary system produces a characteristic filling defect. A tumour produces a tapered narrowing of the lumen.