Injection procedure for cholangiography, percutaneous, complete diagnostic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation; existing access
CPT4 code
Name of the Procedure:
Injection Procedure for Cholangiography, Percutaneous, Complete Diagnostic Procedure including Imaging Guidance (e.g., Ultrasound and/or Fluoroscopy) and all Associated Radiological Supervision and Interpretation; Existing Access
Summary
This is a diagnostic medical procedure where a contrast dye is injected through an existing access point into the bile ducts to obtain imaging. The procedure uses imaging guidance like ultrasound or fluoroscopy to visualize the bile ducts.
Purpose
Cholangiography helps to diagnose and evaluate conditions affecting the bile ducts, such as blockages, strictures, or abnormalities. The goal is to get detailed images of the bile ducts to guide treatment decisions.
Indications
- Jaundice (yellowing of the skin)
- Suspected bile duct obstruction
- Abnormal liver function tests
- Unexplained abdominal pain
- Suspected bile duct tumors or stones
Preparation
- Fasting for 6-8 hours before the procedure.
- Adjustments to medications as instructed by the doctor.
- Pre-procedure blood tests and imaging studies.
Procedure Description
- The patient is positioned, and the existing access point is prepared.
- Using imaging guidance like ultrasound or fluoroscopy, a contrast dye is injected into the bile ducts.
- Detailed images are taken to assess the bile ducts.
- Post-injection, radiological supervision and interpretation of images are done.
Tools and Equipment:
- Contrast dye
- Imaging equipment (ultrasound and/or fluoroscopy)
- Sterile medical supplies
Anesthesia or Sedation: Local anesthesia may be applied at the injection site.
Duration
The procedure typically takes about 30-60 minutes.
Setting
This procedure is usually performed in a hospital or an outpatient clinic with radiology facilities.
Personnel
- Radiologist
- Radiologic technologist
- Nursing staff
- Sometimes an anesthesiologist if sedation is used
Risks and Complications
- Infection
- Bleeding
- Allergic reaction to contrast dye
- Bile leak
- Pancreatitis (rare)
Benefits
- Accurate diagnosis of bile duct conditions.
- Provides a clear visual pathway for potential therapeutic interventions.
- Results are typically available shortly after the procedure.
Recovery
- Observation for a few hours post-procedure.
- Instructions on diet and activities.
- Watch for signs of complications like fever or intense pain.
- Follow-up appointment for result discussion.
Alternatives
- Magnetic Resonance Cholangiopancreatography (MRCP)
- Endoscopic Retrograde Cholangiopancreatography (ERCP)
- Non-invasive imaging techniques like ultrasound or CT scans
Patient Experience
During the procedure, patients might feel mild discomfort or pressure at the injection site. Post-procedure, some may have minor soreness or bruising. Pain management options and comfort measures will be provided as needed.