Wound healing and complications of the liver after percutaneous transhepatic cholangiography

A total of 10 autopsy cases who had received percutaneous transhepatic cholangiography (PTC) were examed and analysed from the view point of chronological changes of hepatic damage caused by the puncture. The conclusion obtained on the process of simple healing can be summarized as follows: (1) Hemocoagulation or hematoma formation on the hepatic surface and intra-peritoneal hemorrhage were seen until the 7th day after PTC but not in cases of the 13th day or later, while the scar of puncture was recognizable on the hepatic capsule in cases of up to the 16th day but was not remaining in ones of the 41st day and later. (2) Damage of the hepatic parenchyma was existing until the 7th day, which, however, was repaired by the 13th day. (3) Intra-hepatic hematoma was seen until the 13th day but faded away thereafter. Namely, intrahepatic trauma caused by PTC seems to be completely cured without leaving any scar in about a half month. However, the puncture trace on the diaphragm was seen in one case of the 42nd day after PTC examination, therefore the nature of diaphragmatic trauma seems to be somewhat different from that of the liver, including its capsule. Besides, discussions are also made on some hepatic complications caused by PTC, as well as on clinical significance of this kind of pathomorphological study.