Percutaneous management of benign biliary strictures

The interventional radiologist plays an increasing role in the management of patients with benign biliary disease. This article summarizes the percutaneous management of patients with benign biliary strictures and includes a discussion of currently available techniques. The techniques of percutaneous transhepatic cholangiography and biliary drainage will be reviewed. This includes anatomic and technical considerations of the right midaxillary and left subxyphoid percutaneous approaches, a review of percutaneous dilation of biliary strictures and the management of patients with chronic indwelling biliary drainage catheters. (ie, periodic catheter exchanges, catheter flushing, etc). The article concludes with a discussion of biliary drainage catheters and the clinical and physiologic parameters used in making a decision to remove the tube.