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Biliary Interventions

Biliary interventions are minimally invasive procedures performed to treat blockages or narrowing in bile ducts. In addition, minimally invasive techniques can be used to treat an inflamed or infected gallbladder.

Biliary interventions include percutaneous transhepatic cholangiography (PTC), an x-ray procedure that involves the injection of a contrast material directly into the bile ducts inside the liver to produce pictures of the bile ducts. If a blockage or narrowing is found, additional procedures may be performed, including:

  • Insertion of a catheter to drain excess bile out of the body
  • Removal of gallstones, stone-like objects that form in the gallbladder or bile ducts.
  • Stent placement, in which a small plastic or metal tube is placed inside a duct to help it remain open or to bypass an obstruction and allow fluids to drain internally

Your doctor may recommend Biliary Interventions for several reasons including:

  • Inflammation - pancreatitis (inflammation of the pancreas), inflammation of the bile ducts
  • Tumors - cancer of the pancreas, gallbladder, bile duct, liver, or enlarged lymph nodes due to a variety of different tumors
  • Gallstones, either in the gallbladder or in the bile ducts
  • Injury to the bile ducts during surgery
  • Infection

Patients are routinely given antibiotics prior to this procedure. You may have blood drawn prior to your procedure. You may be instructed not eat or drink anything for several hours before your procedure. You may be asked to remove some or all of your clothes and to wear a gown during the exam. You may also be asked to remove jewelry, eye glasses and any metal objects or clothing that might interfere with the x-ray images. You should plan to have a relative or friend drive you home after your procedure. Some biliary interventions require an overnight stay at the hospital.

In this procedure, x-ray equipment, ultrasound or CT scanning may be used for image guidance. In addition, additional equipment such as an:

  • Catheter: a long, thin plastic tube, about as thick as a strand of spaghetti.
  • Balloon: a long, thin plastic tube with a small balloon at its end.
  • Stent: a small, wire mesh or plastic tube.
  • Endoscope: an illuminated optical instrument used to examine inside the body.
  • Laparoscope: a thin, tube-like instrument with a light and a lens for viewing the inside of the abdominal cavity

These procedures may be done on an outpatient basis. However, some procedures may require admission. Please consult with your physician. You may be given medications to help prevent nausea and pain, and antibiotics to help prevent infection. A very small nick is made in the skin at the site. A thin needle is inserted through the skin below the ribs and into the liver using x-ray (fluoroscopy) guidance. A contrast material is injected into the liver and bile ducts and x-rays are taken. If a blockage is found, a catheter may be temporarily left in the liver to drain bile into the small intestine or a collection bag outside the body. Stent placement: using image-guidance, a stent may be placed in a narrow portion of a bile duct to help keep the duct open. A balloon-tipped catheter may be used to help expand a narrow duct.

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