Introduction

Article Outline

• Acknowledgment
• Copyright

Despite being considered one of the older disciplines of interventional radiology, minimally invasive transhepatic and/or percutaneous transcholecystic interventions in the management of biliary disease is an exciting area with many advances. A resurgence in percutaneous management of biliary disease has occurred partly because of the growing liver transplant recipient population, which is less amenable to endoscopic retrograde cholangiopancreatography (ERCP), and partly because of recognition that percutaneous access sometimes provides a more efficient and effective means of accomplishing various diagnostic and/or therapeutic maneuvers compared with less direct transoral endoscopic routes.

Biliary interventions should not be considered merely transhepatic biliary access or drainage. Certainly percutaneous biliary access is the first step before further and more advanced biliary interventions. However, interventional radiologists should be aware, train, and educate referring clinicians about their therapeutic capabilities and about what interventional radiology can do to mange biliary disease in both native and transplanted livers.

This biliary issue of Techniques in Vascular Inteventional Radiology discusses conventional percutaneous transhepatic cholangiography and the basic principles of percutaneous biliary tract access and drainage, including transhepatic and transcholecystic techniques. In addition, an overview of approaching and managing malignant biliary occlusion and transplant biliary disease are discussed. Management of bleeding complications after biliary access is also discussed. The subsequent biliary issue discusses unconventional cholangiography and biliary interventions beyond percutaneous access/drainage.

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Acknowledgment 

The guest editors would like to thank all the authors and their ancillary staff including: secretaries, artist and graphic designers who have helped make the Liver transplant issue and the two recent biliary issues of Techniques in Vascular Interventional Radiology. A special thanks to our artists and graphic designers: Margaret Kowaluk, Katie Tower and Patricia Everitt who through their dedication to their work and to detail made our artistic work unique and these issues possible.