Biliary interventions are interventional radiology procedures that treat blockages of the bile duct. Bile ducts connect the liver to the intestine and the liver to the gallbladder. When bile ducts are blocked due to gallstones, congenital defects or other issues, bile that is produced in the liver cannot be passed to the intestine, and your body is not able to digest fat in foods. This can result in jaundice and other conditions.
Interventional radiology techniques allow placement of biliary stents or drainage tubes through a tiny incision. The interventional radiologist uses live imaging (X-ray and ultrasound) to precisely guide the stent or tube to the correct location.
The most common biliary interventions are:
- Biliary stent. During a biliary stent procedure, a plastic tube is placed inside a bile duct. This allows bile to pass freely from the liver to the intestine.
- Biliary drainage. During biliary drainage, a plastic tube is inserted into the liver. This tube ends outside the body, allowing bile to be drained out of the body from the liver.
- Cholecystostomy. Cholecystostomy involves placing a plastic tube into the gallbladder to drain bile so that it does not cause swelling or other complications in the gallbladder. The bile exits the body through the tube and is collected in a drainage bag.
- Biliary endoscopic laser lithotripsy. Biliary endoscopic laser lithotripsy precisely targets gallstones or blockages in the bile ducts with laser light, allowing the blockage to be broken up into small pieces and washed away.
- Percutaneous stone retrieval. During a percutaneous stone retrieval procedure, the interventional radiologist uses a special tool to either remove fragments of bile duct and gallstones through a small tube or push them through the bile duct into the intestines where they will pass out of the body naturally.
What to Expect
What to Expect
A biliary intervention includes the following steps:
- Your child will be given a sedative or put to sleep and monitored closely by an anesthesiologist.
- The interventional radiologist will guide a needle to the proper location and inject dye to make the area more visible through imaging.
- The interventional radiologist will then guide the biliary tube or stent into place.
- Once the procedure is complete, your child will be taken to a recovery room to wake up.
- After your child awakens, he or she will be taken to a hospital room for care and observation. Your child will have some pain, so he or she may be given pain medicine. You should expect a stay of at least one night.
- If your child has a drainage tube, the nurse will show you how to care for the place where the tube comes out of your child’s body.
Every three months, your child must come back to have the old drainage tube exchanged for a new one. The procedure allows the doctor to examine the site of the tube and reduces the chance of clogging or infection.
Like all procedures, biliary interventions have a few risks. Sometimes a child has bleeding where the drainage tube comes out of the body. In rare cases, infection is possible, or a child may be allergic to the dye used during the procedure. Damage to nearby organs (such as the liver or lungs) is also possible.
Key Points to Remember
Key Points to Remember
- Bile ducts allow bile to pass from the liver to the intestine and gallbladder. Biliary interventions treat blocked bile ducts using a biliary stent or drainage tube.
- Your child will be under sedation during a biliary intervention procedure.
- Biliary intervention requires at least an overnight stay in the hospital.
- A nurse will show you how to drain bile from the drainage tube. Your child must return every three months for a new tube.
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