Interventional radiology in the management of bile duct injuries

The advent of laparoscopic cholecystectomy has brought an increased number of bile duct injuries to the attention of surgeons and interventional radiologists. The spectrum of injury ranges from cystic duct stump leakage to partial obstruction to complete occlusion of the ducts and common hepatic or common bile duct ischemic strictures. The proper therapy for any given patient may be surgical or nonsurgical. Frequently, interventional radiologic techniques permit successful nonoperative drainage of postoperative fluid collections and percutaneous management of bile duct injury and stricture. In some patients in whom radiologic techniques are not successful or in whom the extent of injury requires surgical repair, interventional radiologic techniques can provide preoperative anatomic definition of the extent of injury as well as catheter localization of intrahepatic duct strictures before proximal hepaticojejunostomy.