Interventional radiology in the biliary tract.

Abstract

Numerous papers have appeared in the past year outlining the expanded role of the radiologist in the treatment of patients with biliary disease, including papers describing palliative treatment of patients with obstructive jaundice due to malignant disease using self-expanding metallic biliary endoprostheses placed percutaneously, extracorporeal shock-wave lithotripsy used to treat patients with gallstones and intrahepatic stones, percutaneous rotational contact biliary lithotripsy, pulsed dye laser biliary lithotripsy, percutaneous biliary intervention via a minicholecystotomy, conventional percutaneous fluoroscopic management of bile duct stones, and percutaneous management of biliary strictures including transluminal biopsy. Percutaneous evaluation and treatment of patients with biliary disease using cholangioscopy as an adjuvant to biliary intervention, radionuclide imaging for improved evaluation of suspected biliary injury after laparoscopic cholecystectomy, and percutaneous treatment of the critically ill patient with cholecystitis or the patient with a perforated gallbladder are also discussed. Diagnostic and therapeutic options available to radiologists for treating patients with biliary disease are summarized.