Interventions of the Biliary Tract

Imaging plays a major role not only in diagnosing the cause of biliary obstruction but also in guiding biliary drainage. Percutaneous biliary drainage is preferred in patients with proximal biliary obstruction and in those in whom endoscopic drainage has been unsuccessful or is not feasible due to surgically altered anatomy. Pre-procedure evaluation of coagulation parameters and prophylactic antibiotic administration are necessary to reduce the incidence of hemorrhagic complications and cholangitis. Various adjunct procedures such as brush biopsy, brachytherapy, and stone extraction can be done through percutaneous biliary access. Percutaneous metallic stent placement helps to relieve the symptoms of obstructive jaundice in patients with unresectable or metastatic cancers. Percutaneous cholecystostomy is done in patients with cholecystitis due to gall bladder calculi and are not candidates for cholecystectomy and in patients with acalculous cholecystitis.