Palliative Percutaneous Biliary Interventions in Malignant High Bile Duct Obstruction

Deipolyi, Amy R.; Covey, Anne M.

doi:10.1055/s-0037-1608827

Cited by 13 publications

(23 citation statements)

References 52 publications

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“… 133 Delayed bleeding (after 3–7 days of PTBD) is usually due to arterial injury. 133 134 Bleeding may occur into the perihepatic space and peritoneal cavity. Since PTBD is an invasive procedure, some amount of blood in the drain is normal during the initial 24 to 48 hours.…”

Section: Methodsmentioning

confidence: 99%

Indian College of Radiology and Imaging Evidence-Based Guidelines for Percutaneous Image-Guided Biliary Procedures

Madhusudhan

Valakkada

Keshava

2021

Indian J Radiol Imaging

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Percutaneous biliary interventions are among the commonly performed nonvascular radiological interventions. Most common of these interventions is the percutaneous transhepatic biliary drainage for malignant biliary obstruction. Other biliary procedures performed include percutaneous cholecystostomy, biliary stenting, drainage for bile leaks, and various procedures like balloon dilatation, stenting, and large-bore catheter drainage for bilioenteric or post-transplant anastomotic strictures. Although these procedures are being performed for ages, no standard guidelines have been formulated. This article attempts at preparing guidelines for performing various percutaneous image-guided biliary procedures along with discussion on the published evidence in this field.

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Section: Methodsmentioning

confidence: 99%

Indian College of Radiology and Imaging Evidence-Based Guidelines for Percutaneous Image-Guided Biliary Procedures

Madhusudhan

Valakkada

Keshava

2021

Indian J Radiol Imaging

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“…Interventional radiologist plays an adjunctive role in preoperative management of cholangitis and postoperative biliary leaks by placing percutaneous drains under USG, CT, or fluoroscopic guidance[ 88 ]. Percutaneous drainage of the biliary system and biliary stenting are widely used methods for palliative care in GBC[ 89 ]. Percutaneous cholecystostomy is an interventional technique that is primarily employed in biliary emergencies like acute severe cholecystitis and cholangitis.…”

Section: Role Of Interventional Radiology In Gb Pathologiesmentioning

confidence: 99%

Imaging-based algorithmic approach to gallbladder wall thickening

Gupta¹,

Marodia²,

Bansal³

et al. 2020

WJG

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Gallbladder (GB) wall thickening is a frequent finding caused by a spectrum of conditions. It is observed in many extracholecystic as well as intrinsic GB conditions. GB wall thickening can either be diffuse or focal. Diffuse wall thickening is a secondary occurrence in both extrinsic and intrinsic pathologies of GB, whereas, focal wall thickening is mostly associated with intrinsic GB pathologies. In the absence of specific clinical features, accurate etiological diagnosis can be challenging. The survival rate in GB carcinoma (GBC) can be improved if it is diagnosed at an early stage, especially when the tumor is confined to the wall. The pattern of wall thickening in GBC is often confused with benign diseases, especially chronic cholecystitis, xanthogranulomatous cholecystitis, and adenomyomatosis. Early recognition and differentiation of these conditions can improve the prognosis. In this minireview, the authors describe the patterns of abnormalities on various imaging modalities (conventional as well as advanced) for the diagnosis of GB wall thickening. This paper also illustrates an algorithmic approach for the etiological diagnosis of GB wall thickening and suggests a formatted reporting for GB wall abnormalities.

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“…This approach is indicated after failure of ERCP-guided drainage and in cases of proximal extrahepatic biliary obstruction in which the stent cannot be placed using ERCP or in cases of intrahepatic biliary obstruction. The technique enables selective and direct access to intrahepatic bile ducts, thus avoiding contamination of the tract on crossing the papilla[54]. If the guidewire manages to reach the duodenum, an internal/external biliary drainage catheter is inserted.…”

Section: Palliative Biliary Drainagementioning

confidence: 99%

Diagnostic-therapeutic management of bile duct cancer

Huguet¹,

Lobo²,

Labrador³

et al. 2019

WJCC

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Biliary tract cancer, or cholangiocarcinoma, comprises a heterogeneous group of malignant tumors that can emerge at any part of the biliary tree. This group is the second most common type of primary liver cancer. Diagnosis is usually based on symptoms, which may be heterogeneous, and nonspecific biomarkers in serum and biopsy specimens, as well as on imaging techniques. Endoscopy-based diagnosis is essential, since it enables biopsy specimens to be taken. In addition, it can help with locoregional staging of distal tumors. Endoscopic retrograde cholangiopancreatography is a key technique for the evaluation and treatment of malignant biliary tumors. Correct staging of cholangiocarcinoma is essential in order to be able to determine the degree of resectability and assess the results of treatment. The tumor is staged based on the TNM classification of the American Joint Committee on Cancer. The approach will depend on the classification of the tumor. Thus, some patients with early-stage disease could benefit from surgery; complete surgical resection is the cornerstone of cure. However, only a minority of patients are diagnosed in the early stages and are suitable candidates for resection. In the subset of patients diagnosed with locally advanced or metastatic disease, chemotherapy has been used to improve outcome and to delay tumor progression. The approach to biliary tract tumors should be multidisciplinary, involving experienced endoscopists, oncologists, radiologists, and surgeons.

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Palliative Percutaneous Biliary Interventions in Malignant High Bile Duct Obstruction

Cited by 13 publications

References 52 publications

Indian College of Radiology and Imaging Evidence-Based Guidelines for Percutaneous Image-Guided Biliary Procedures

Indian College of Radiology and Imaging Evidence-Based Guidelines for Percutaneous Image-Guided Biliary Procedures

Imaging-based algorithmic approach to gallbladder wall thickening

Diagnostic-therapeutic management of bile duct cancer

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