transhepatic

Transhepatic is a medical term describing routes, access, or procedures that pass through the liver (hepatic tissue). It is commonly used to describe percutaneous approaches that traverse the liver to reach structures outside or within the biliary or vascular systems, or to obtain tissue samples.

Common transhepatic procedures include Percutaneous transhepatic cholangiography (PTC), in which contrast is injected through a needle or catheter inserted via the liver into the biliary tree for imaging. Percutaneous transhepatic biliary drainage (PTBD) uses a catheter placed through the liver to drain obstructed bile ducts. Percutaneous liver biopsy involves inserting a needle through the liver capsule to obtain tissue for histologic examination. Transhepatic portography or portal venography describes imaging of the portal venous system via a transhepatic puncture.

Transhepatic access is typically guided by ultrasound or computed tomography and performed under local anesthesia with sedation as needed. Indications include biliary obstruction, evaluation of biliary anatomy, liver lesion sampling, and certain diagnostic or therapeutic interventions requiring access through the hepatic parenchyma. Risks associated with transhepatic procedures include bleeding, bile leakage or peritonitis, infection, injury to surrounding organs, and pain at the entry site. Patients with coagulopathy or significant ascites may face higher complication risks.

Alternatives to transhepatic routes include endoscopic approaches such as ERCP for biliary drainage or transjugular methods for biopsy or shunting, chosen based on anatomy, underlying disease, and patient condition. The term remains a general descriptor of any technique that requires traversing the liver to reach a target.