Introduction

Article Outline

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Despite being considered one of the older disciplines of interventional radiology, minimally invasive transhepatic and/or percutaneous transcholecystic interventions in the management of biliary diseases is an exciting area with many advances. A resurgence in percutaneous management of biliary disease has occurred. This is 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 capablities and what interventional radiology can offer to manage biliary disease in both native and transplanted livers.

This biliary issue of techniques in vascular interventional radiology is a continuation of the previous biliary issue. The current issue discusses noninvasive cholangiography, unconventional cholangiography, and biliary interventions beyond percutaneous access and drainage. The previous biliary issue discussed biliary access as well as an overview of management of malignant biliary obstruction, transplant biliary complications, and postbiliary access bleeding.