Biliary Drainage

Interventional radiologists play a key role in the diagnosis and management of patients with benign and malignant biliary disease. Noninvasive tools such as ultrasound, magnetic resonance cholangiopancreatography (MRCP), and computed tomographic cholangiography (CT cholangiography) can be used to identify biliary pathology. More invasive techniques such as endoscopic retrograde cholangiography (ERC) with or without endoscopic ultrasound (EUS), percutaneous transhepatic cholangiography (PTC), and transhepatic imaging-guided biopsy can be used to clarify the extent of disease and secure a diagnosis. Once a diagnosis has been determined, patients with biliary obstruction or leak may benefit from percutaneous drainage as a prelude to definitive surgical intervention or as a palliative treatment for patients with malignant obstruction.