[Cholestasis: interventional therapy]

Treatment of cholestasis by bile duct obstruction is nowadays dominated by endoscopy and other interventional measures. Intraductal concrements can be removed almost always without open surgery. This is as a rule achieved by a transpapillary approach with the additional use of lithothripsy. Percutaneous transhepatic treatment of concrements is restricted to patients in which a transpapillary approach is impossible. Stenoses of biliary ducts by malignancies are treated with plastic or metallic endoprosthesis if curative resection is precluded. Percutaneous drainage is a valid option in reserve. Stenosis of the papilla by scars, tumors or sphincter dysfunction are mainly treated endoscopically, malignancies--if possible--by radical surgery. Rare causes for obstruction have also to be considered. They are in most instances amenable to interventional procedures.