Biliary Intervention at Sky Ridge Medical Center

Biliary interventions are minimally invasive procedures performed to treat blockages or narrowing in bile ducts.

Bile, a fluid that helps digest fat in foods, is produced in the liver and flows through ducts or tubular passageways leading to the gallbladder where it is stored. When needed, the gallbladder contracts and releases bile through ducts into the small intestine.

If the bile ducts become blocked, bile cannot pass into the intestine and this may result in jaundice (in which the level of bile products in the blood becomes elevated). If the jaundice becomes severe, the patient will appear to have a yellowish hue, particularly in the whites of the eye. If the duct that connects the gallbladder to the rest of the bile ducts becomes blocked (usually due to gallstones in the gallbladder), this results in inflammation or infection (cholecystitis). This is generally treated by surgical removal of the gallbladder — either laparoscopically (minimally invasive) or by conventional open surgery. However, when patients are too ill to undergo surgical cholecystectomy, a percutaneous cholecystectomy may be performed by an interventional radiologist.

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.
  • Percutaneous cholecystostomy, a minimally invasive procedure in which a tube is placed in the gallbladder under imaging guidance in order to decompress a distended, inflamed and usually infected gallbladder. This procedure is typically done in patients who are too ill to undergo cholecystectomy. It is usually performed by an interventional radiologist.

Common Uses of a Biliary Intervention

There are several conditions that can cause a blockage or narrowing in bile duct, including:

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