Percutaneous endoscopy for biliary radiologic interventions

Biliary endoscopy is an adjunct to percutaneous biliary interventions. Although there are technical and cost considerations, the interventional radiologist may apply this useful tool to patients with a wide range of biliary diseases (eg, patients with retained intrahepatic stones, patients with suspected lesions requiring biopsy, etc). Discussed in this article are advantages, disadvantages, patient preparation, technical advice, complications, and a review of the literature. Percutaneous biliary endoscopy, applied through a transhepatic tube tract or a mature T tube tract, reduces radiation exposure to the patient and health care personnel in the room. The procedure is generally performed on an outpatient basis under conscious sedation. Given access to a choledochofiberscope and familiarity with its use, percutaneous endoscopy for biliary radiologic interventions is a valuable technique and may be used to manage patients with complex biliary disease.