Techniques to Facilitate the Difficult Percutaneous Transhepatic Biliary Drainage

Abstract In most patients, percutaneous biliary drainage is a straightforward procedure. However, problems may be encountered and are usually due to difficulties in opacification of nondilated ducts, tight hilar lesions, or isolated biliary segments. Solutions to the first problem involve injection...

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Bibliographic Details
Published in:Seminars in interventional radiology 1996-09, Vol.13 (3), p.241-252
Main Authors: Lund, Gunnar B., Johnson, Matthew
Format: Article
Language:English
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Summary:Abstract In most patients, percutaneous biliary drainage is a straightforward procedure. However, problems may be encountered and are usually due to difficulties in opacification of nondilated ducts, tight hilar lesions, or isolated biliary segments. Solutions to the first problem involve injection of ancillary tubes, the gallbladder, or the common bile duct. Retrograde catheterization of the segment with placement of stable radiopaque targets such as snares, wires, or catheters are helpful. Carbon dioxide may be useful as a contrast agent in nondependent ducts. Tight lesions and isolated segments can be approached after “through-and-through” access has been established. This article discusses and illustrates some of the concepts that have been developed to achieve biliary drainage in such patients.
ISSN:0739-9529
1098-8963
DOI:10.1055/s-2008-1057909